Anatomy
Joints
Neuro CCS
Radiology
Complementary Medicines
100

What bone forms the largest portion of the floor of the orbit?

Maxillary bone 

100

What are the two main layers of the synovial membrane, and what are their key features?

Intimal layer – 1–3 cells thick; contains type A (macrophage-like) and type B (fibroblast-like) synoviocytes.

Subintimal layer – loose connective tissue, blood vessels, lymphatics, nerves.

100

If a patient’s leg shows spasticity and brisk reflexes, is this more likely an upper or lower motor neurone lesion?

Upper Motor Neurone

100

What typical radiographic finding is seen in Osgood–Schlatter disease, and what anatomical structure is involved

Fragmentation and irregularity of the tibial tuberosity apophysis, due to traction from the patellar tendon

100

Why might a patient describe complementary medicines as “non-chemical,” and why is this scientifically inaccurate?

They see them as “natural,” but scientifically everything is made of chemicals, including herbal and vitamin products.

200

What is the name of the first cervical vertebrae (C1)?

Atlas

200

Which cell type in the synovium is primarily responsible for producing hyaluronic acid and lubricin, and what is their function?

Type B synoviocytes; produce hyaluronic acid and lubricin for joint lubrication and shock absorption.

200

Which reflex tests the L3/L4 spinal level?

Knee jerk / patellar reflex

200

Identify the condition 


Osgood-Schlatter Disease

200

What enzyme does St John’s wort induce, and what is the clinical consequence for women taking the combined oral contraceptive pill?

Induces CYP3A4 → lowers hormone levels → risk of breakthrough bleeding, ovulation, and pregnancy.

300

Through which foramen does the mandibular nerve (V3) exit the skull?

Foramen Ovale

300

When performing arthrocentesis on the knee, list the layers a needle penetrates (anterolateral approach).

Skin → subcutaneous tissue (fat/adipose) → quadriceps tendon or retinaculum → joint capsule → synovial membrane → joint space for synovial fluid collection

300

What movement would be weak in a common peroneal/fibular nerve injury?

Foot dorsiflexion (foot drop)

300

How do you differentiate between a normal growth plate (physis) and a fracture line on a child's xray?

Growth plate is smooth, regular, symmetric, with sclerotic margins; 

Fracture lines are irregular, lucent, may extend into metaphysis/epiphysis and often asymmetrical.

300

If a product has an AUST L number but no “(A)” after it, what does that specifically mean about how it was assessed by the TGA?

Assessed for quality and safety, but not efficacy.

400

Which cervical vertebra has the most prominent spinous process and where is it usually palpable

C7 - usually palpable at the base of the neck

400

What are 3 functions of synovial fluid?

Shock absorption

Nourishment of cartilage

Immune surveillance / removal of debris

400

What does weakness in all four limbs with brisk reflexes and extensor plantar responses suggest and why?

Cervical cord or bilateral pyramidal lesions

All limbs = spinal cord --> cervical cord

Reflexes are from local circuits and do not require input from the brain 

Even if the upper motor neurone pathway (corticospinal tract) is damaged, the reflex arc at the spinal level is intact

400

Identify the marked feature and describe its location


Growth plate of the proximal humerus
400

What proportion of Australians report using at least one complementary medicine in the past year, and which demographic is the highest user group?

~70% of Australians; younger to middle-aged women with higher income and education.

500

In portal hypertension, bleeding esophageal varices arise from communication between which two veins?

Left gastric vein (portal) and azygos vein (systemic).

500

Why does the synovium play a central role in inflammatory arthritis (e.g. rheumatoid arthritis)?

It is highly vascular, contains immune cells, and can proliferate (pannus formation) → releases cytokines/enzymes → cartilage and bone destruction.

500

What does a positive Babinski sign look like, and what does it mean?

Plantar Reflex --> Big toe extends upwards; indicates an UMN lesion.

500

What are the classic features of osteoarthritis seen at synovial joints

Joint space narrowing, 

subchondral sclerosis,

osteophyte formation, 

subchondral cysts

500

At what daily dose of vitamin E do adverse outcomes like haemorrhagic stroke and increased mortality become more likely?

≥400 IU/day.

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