Exam Pathologies - Neck of Femur Fracture

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Questions and Answers

What characterizes an intracapsular fracture?

It includes intertrochanteric fractures.

It is located within the joint capsule. (correct)

It is associated with poor blood supply.

It occurs outside the joint capsule.

Which of the following is a common symptom of knee osteoarthritis?

Always asymptomatic

Joint swelling/effusion (correct)

Constant warm sensation in the joint

Increased joint stability

What is a primary risk factor for developing knee osteoarthritis?

Obesity (correct)

Young age

Maintenance of strong quadriceps

High physical activity levels

How does weak quadriceps contribute to knee issues?

Worsens wear and tear on the knee Signup and view all the answers

Which of the following is NOT a pathophysiological change associated with knee osteoarthritis?

Increased cartilage production Signup and view all the answers

Which condition may arise due to immobilization following an injury?

Deep vein thrombosis (DVT) Signup and view all the answers

What common compensatory mechanism may occur due to pain from knee osteoarthritis?

Antalgic gait Signup and view all the answers

Which type of fracture occurs outside the joint capsule?

Intertrochanteric fracture Signup and view all the answers

What is considered the gold standard pharmacological treatment for motor symptoms in Parkinson's Disease?

Levodopa + Carbidopa Signup and view all the answers

Which of the following is a non-pharmacological management approach for patients with Parkinson's Disease?

Physiotherapy for mobility Signup and view all the answers

Which of the following symptoms is part of the TRAP mnemonic for Parkinson's Disease?

Postural instability Signup and view all the answers

Dysarthria in Parkinson's Disease primarily affects which aspect of function?

Communication Signup and view all the answers

What characterizes Chronic Obstructive Pulmonary Disorder (COPD)?

Chronic airflow limitation Signup and view all the answers

Which imaging technique may assist in diagnosing Parkinson's Disease if the diagnosis is uncertain?

DaTscan Signup and view all the answers

Which of the following non-motor symptoms can occur in advanced stages of Parkinson's Disease?

Cognitive impairment Signup and view all the answers

What is a common complication related to Levodopa treatment in Parkinson's Disease?

Dyskinesia Signup and view all the answers

What is a primary characteristic of a Grade II ligament injury?

Moderate swelling and bruising Signup and view all the answers

Which type of shoulder dislocation is the most common?

Anterior dislocation Signup and view all the answers

What is an initial management step for a shoulder dislocation?

Immediate reduction under sedation Signup and view all the answers

What condition can complicate an anterior shoulder dislocation?

Bankart lesions Signup and view all the answers

What type of physiotherapy is emphasized during the rehabilitation phase after a shoulder dislocation?

Strengthening rotator cuff and scapular stabilizers Signup and view all the answers

What is a common cause of posterior shoulder dislocation?

Seizures and electric shocks Signup and view all the answers

What might numbness or tingling indicate in a shoulder dislocation scenario?

Axillary nerve injury Signup and view all the answers

Which factor is NOT commonly associated with Grade III ligament injuries?

Partial ligament tear Signup and view all the answers

Which imaging technique is indicated for assessing soft tissue injuries in suspected cases of dislocation?

MRI Signup and view all the answers

What is the first-line pharmacological treatment for managing pain and inflammation in Axial Spondylitis?

NSAIDs Signup and view all the answers

Which condition is characterized by early stages with no visible changes on X-ray but detectable inflammation via MRI?

Non-Radiographic AxSpA Signup and view all the answers

What is a common clinical presentation in patients with Ankylosing Spondylitis?

Chronic back pain with morning stiffness Signup and view all the answers

What is the primary goal during the acute phase of managing an ankle sprain?

Implement the RICE protocol Signup and view all the answers

What complication is specifically associated with advanced stages of Axial Spondylitis?

Bamboo spine Signup and view all the answers

Which of the following is a non-pharmacological management technique for Axial Spondylitis?

Regular exercise focusing on posture Signup and view all the answers

Which ligament is most frequently sprained in lateral ankle sprains?

Anterior talofibular ligament Signup and view all the answers

What risk factor is strongly associated with Axial Spondylitis?

HLA-B27 genetic marker Signup and view all the answers

What clinical feature is commonly associated with a ligament injury around the ankle joint?

Swelling and bruising Signup and view all the answers

In which scenario is surgical intervention typically indicated for patients with Axial Spondylitis?

For severe spinal deformities or joint replacements Signup and view all the answers

What is primarily affected in bone wear due to cartilage deterioration?

Joint lubrication Signup and view all the answers

Which of the following is a risk factor for ankle sprain?

Previous ankle sprain Signup and view all the answers

What management strategy is aimed at enhancing quality of life following an ankle sprain?

ADL adaptations and assistive devices Signup and view all the answers

What is a common clinical feature of synovial inflammation?

Inflamed and thickened synovial membrane Signup and view all the answers

Which movement primarily causes a lateral ankle sprain?

Excessive inversion Signup and view all the answers

What is the primary cause of ischemic stroke?

Clot formation in a cerebral artery Signup and view all the answers

Which imaging technique is better for detecting small ischemic strokes?

MRI Signup and view all the answers

Which of the following is a common symptom indicating a potential stroke?

Sudden onset of severe headache Signup and view all the answers

What is the strongest modifiable risk factor for stroke?

Hypertension Signup and view all the answers

Which of the following is NOT part of the FAST acronym used in stroke recognition?

Time Signup and view all the answers

What is the recommended treatment within 4.5 hours of an ischemic stroke onset?

Thrombolysis with tissue plasminogen activator (tPA) Signup and view all the answers

Which type of stroke is characterized by a temporary blockage and symptoms resolving within 24 hours?

Transient Ischemic Attack (TIA) Signup and view all the answers

Which of the following is NOT a recommended strategy for secondary prevention after a stroke?

Excessive alcohol consumption Signup and view all the answers

Study Notes

Exam Pathologies - Module 358

Neck of Femur Fracture (NOF)
- Definition: A bone break in the proximal femur, specifically in the region just below the femoral head.
- Common clinical features include severe pain in the hip or groin after trauma (e.g., fall), inability to bear weight, shortened and externally rotated leg, increased swelling and bruising around the groin and hip.
- Risk factors include age over 65, female sex (postmenopausal osteoporosis), osteoporosis/osteopenia, falls, smoking, alcohol consumption, and corticosteroid use.
- Causes include low-energy trauma (common in elderly individuals with osteoporosis), and high-energy trauma (common in younger individuals).
- Classification by anatomical location: intracapsular (within the joint capsule - sub-capital, transcervical fractures) and extracapsular (outside the capsule - intertrochanteric, subtrochanteric fractures).
- Complications include avascular necrosis (AVN - disruption of blood supply to the femoral head), non-union (poor healing), deep vein thrombosis (DVT), and post-traumatic arthritis.

Knee Osteoarthritis

Definition: A degenerative joint disease of the knee, typically due to wear and tear and progressive loss of articular cartilage.
Risk factors include age, obesity, and previous injuries (trauma, ligament tears, or meniscal injuries).
Pathophysiological changes include cartilage breakdown/joint space narrowing, bone wearing, and synovial inflammation.
Cartilage loss reduces joint space and cushioning, while bone rubbing causes pain, inflammation and bone spurs (osteophytes).
Synovial membrane inflammation leads to pain and swelling by reducing joint lubrication.
Clinical management goals aim to reduce pain/inflammation, improve joint function and mobility, and enhance quality of life.

Ankle Sprain

Definition: A ligament injury around the ankle joint, most commonly involving the lateral ligaments due to excessive inversion.
Clinical features include pain/tenderness over affected ligaments, swelling/bruising around the ankle, reduced range of motion, and difficulty/inability to weight bear.
Classification includes Grade I (mild – microtears), Grade II (moderate – partial tear), and Grade III (severe – rupture).
Risk Factors include previous ankle sprains, weak muscles/poor balance, high-risk sports activities, inappropriate footwear, and obesity/poor fitness.
Management focuses on RICE protocol (rest, ice, compression, elevation) during the acute phase, followed by gentle range of motion exercises, and strengthening exercises (2-6 weeks), balance/proprioception training, and gradual weaning off of braces (6-12 weeks) and referral to physiotherapy for specialized rehabilitation in severe cases.

Shoulder Dislocation

Definition: Displacement of the humeral head from the glenoid cavity, most commonly anterior.
Types include anterior dislocations (most common, caused by abduction, external rotation, extension), posterior dislocations (caused by seizures, electric shocks, or trauma), and inferior dislocations (rare, caused by hyperabduction).
Clinical features include severe shoulder pain, visible deformity (flattened deltoid), limited range of motion, and often numbness and/or tingling (axillary nerve involvement).
Complications include axillary nerve injury, recurrent dislocations, labral tears, and rotator cuff injuries.
Management focuses on immediate reduction under sedation/analgesia, then post-reduction imaging to confirm placement, sling immobilization, gradual physiotherapy, and specialized rehabilitation, including surgical intervention for recurrent dislocations or severe damage.

Axial Spondylitis (AxSpA)

Definition: A chronic inflammatory condition affecting axial skeleton (spine and sacroiliac joints).
Types include non-radiographic AxSpA (early stage with no visible changes on X-ray but detectable inflammation) and ankylosing spondylitis (AS - advanced stage with visible changes like sacroiliitis).
Clinical presentation includes chronic back pain, morning stiffness, pain worse at night/early morning, alternating buttock pain (sacroiliac involvement), and fatigue.
Risk factors include strong genetic association with HLA-B27, more common in males, and family history.
Management includes NSAIDs, biologics (TNF inhibitors, IL-17 inhibitors) for refractory cases, DMARDs, regular exercise, physiotherapy, and smoking cessation to reduce disease progression.

Stroke (CVA)

Definition: A disruption of blood flow to the brain lasting more than 24 hours, causing rapid disturbance of cerebral function.
Types include ischemic stroke (obstruction in cerebral artery) and hemorrhagic stroke (ruptured blood vessel).
Clinical features (FAST acronym): Face drooping, Arm weakness/inability to lift, Speech difficulty, and Time to call for emergency services).
Additional symptoms may include sudden severe headache vision changes, balance issues, and dizziness.
Diagnosis and management typically involve imaging (CT/MRI), blood tests (glucose, cholesterol, clotting profile), cardiac assessment, and focused interventions (thrombectomy, blood pressure control, antiplatelets/anticoagulation).

Parkinson's Disease

Definition: A progressive neurodegenerative disorder caused by dopamine loss, leading to motor and non-motor symptoms.
Clinical features include tremor (resting tremor), rigidity (increased muscle tone), akinesia/bradykinesia (slowness/difficulty initiating movements), postural instability (impaired balance).
Non-motor symptoms include cognitive impairment/dementia, autonomic dysfunction (constipation, orthostatic hypotension), mood disorders, and sleep disturbances.
Management involves pharmacological therapy (Levodopa+carbidopa, dopamine agonists), non-pharmacological interventions (physiotherapy, occupational therapy, speech therapy), and surgical options (Deep Brain Stimulation) for refractory cases.

Chronic Obstructive Pulmonary Disorder (COPD)

Definition: A progressive, irreversible lung disease characterized by chronic airflow limitation due to inflammation, airway narrowing, and alveolar destruction.
Pathophysiology includes inflammation/narrowing of airways (bronchitis), and damage to alveoli (emphysema) from long-term irritants (smoking, pollutants).
Clinical Features include dyspnea (progressive breathlessness), chronic cough, wheezing, reduced exercise tolerance, and cyanosis (in advanced stages).
Risk factors include smoking, long-term exposure to air pollutants/occupational irritants, alpha-1 antitrypsin deficiency, and history of recurrent respiratory infections.
Management aims at smoking cessation, pulmonary rehabilitation, oxygen therapy, bronchodilators (short-acting/long-acting), inhaled corticosteroids, and other supportive measures for exacerbations and respiratory failure.

Coronary Artery Bypass Graft (CABG)

Definition: A surgical procedure to restore blood flow to the heart by creating bypasses around blocked coronary arteries causing reduced perfusion.
Purpose is to improve blood supply to the heart, and reduce risk of heart attacks and other complications due to heart disease.
Indications include severe stenosis of coronary arteries (over 70% narrowing), poor left ventricular function, severe CAD (3 vessel disease), and failure of medical therapy.
Procedure involves harvesting grafts from veins, arteries or synthetic materials, and creating bypasses by connecting the grafts to the aorta and distal to the blocked segment of the coronary artery.
Postoperative care involves monitoring ECG, haemodynamics, and potential complications (e.g., graft occlusion, infection, myocardial infarction).

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Description

This quiz focuses on the neck of femur fractures, detailing their definitions, clinical features, risk factors, and classifications. It provides essential knowledge for understanding fractures in the proximal femur and their implications. Ideal for students studying pathology or related medical fields.