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Clinical Problem Solving > 5 - Joint Pain > Flashcards

5 - Joint Pain Flashcards

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1
Q

List 2 biomarkers for rheumatoid arthritis.

A
  1. Rheumatoid factor

2. Anti-CCP (anti-cyclic citrillunated peptide

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2
Q

Why might a patient with septic arthritis present with fever?

A

Injury lead to infection

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3
Q

The main principle for managing osteoarthritis is halting ___.

A

Progression

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4
Q

What is the most common cause of septic arthritis?

A

Injury

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5
Q

What is the most common surgical treatment for osteoarthritis?

A

Joint replacement

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6
Q

List 2 reasons why rheumatoid factor is an unreliable biomarker for rheumatoid arthritis.

A
  1. Not found in all RA patients

2. Can be found in unaffected patients

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7
Q

When cartilage thins and cracks, what forms on the margins?

A

Osteophytes (bony spurs)

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8
Q

How can osteoarthritis cause genu varum?

A

Abnormal remodelling of joints

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9
Q

What type of joint would be found in the skull?

A

Fibrous

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10
Q

In addition to joints, rheumatoid arthritis can affect other parts of the body. List 4 organs that could be affected by rheumatoid arthritis.

A
  1. Lungs
  2. Eyes
  3. Pleura
  4. Pericardium
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11
Q

What is the most common cause of work absence in Western countries?

A

Back pain

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12
Q

Why does inflammation lead to an increase in blood flow?

A

Blood carries immune cells to the site of infection

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13
Q

What are menisci?

A

Discs of cartilage within certain synovial joints that enhance stability

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14
Q

List 2 serious underlying causes of back pain.

A
  1. Spinal stenosis

2. Bone metastases

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15
Q

What is septic arthritis?

A

Arthritis resulting from infection

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16
Q

Mechanical back pain does not radiate beyond the ___.

A

Knee

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17
Q

How does arthritis cause pain? (Hint: relates to inflammation.)

A

Inflammation -> tissue swelling -> stimulation of pain receptors

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18
Q

List 6 risk factors for osteoarthritis.

A
  1. Genetic
  2. Age
  3. Obesity
  4. Repetitive use
  5. Past injury
  6. Joint misalignment
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19
Q

The main principle for managing rheumatoid arthritis is the reduction of ___.

A

Inflammation

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20
Q

Compare the range of movement allowed by the 3 joint types.

A

Fibrous: None
Fibrocartilaginous: Some
Synovial: Extensive

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21
Q

What is the main function of synovial fluid?

A

Lubrication

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22
Q

What class of medication increases risk of gout?

A

Diuretics

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23
Q

What type of joint would be found in the limbs?

A

Synovial

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24
Q

Which type of arthritis is caused by the DEGENERATION of cartilage?

A

Osteoarthritis

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25
Which connective tissue covers the surface of a synovial joint?
Cartilage
26
What type of liquid does the joint cavity contain?
Synovial fluid
27
What form of connective tissue holds joints together?
Ligaments
28
Joints are held together by ligaments. What is the main protein in a ligament?
Collagen
29
List the 3 types of joints.
1. Fibrous 2. Fibrocartilaginous 3. Synovial
30
List 3 potential investigations for arthritis.
1. Aspiration 2. X-rays 3. Blood test
31
What is subchondral sclerosis?
Abnormally thickened bone just below the cartilage
32
Compare mono-arthritis and poly-arthritis.
Mono-arthritis: affects one join | Poly-arthritis: affects multiple joints
33
What is the most effective pharmacological treatment for rheumatoid arthritis?
DMARDs
34
List 3 signs of rheumatoid arthritis specific to the hands.
1. MCP joint displacement 2. Z deformity of the thumb 3. Ulnar deviation
35
What are pseudo-gout crystals made up of?
Pyruvic acid
36
How does arthritis cause swelling? (Hint: relates to inflammation.)
Inflammation -> increased flow of fluids (i.e., blood and lymph) to the area
37
How might kidney disease result in gout?
Less filtering of purines leads to uric acid buildup from purine breakdown
38
What is spinal stenosis?
Narrowing of the spinal canal, resulting in pressure on the spinal cord
39
Define articular.
Related to the joints
40
What is the name for discs of cartilage within certain synovial joints that enhance stability?
Menisci
41
List 3 risk factors for rheumatoid arthritis.
1. Genetic (60%) 2. Female 3. 40+
42
Morning stiffness is a classic sign of ___ arthritis.
Rheumatoid
43
List 3 treatments for mechanical back pain.
1. Painkillers 2. Rest 3. Physiotherapy
44
Which type of arthritis causes by autoimmune THICKENING of the synovial membrane?
Rheumatoid arthritis
45
How does arthritis cause redness? (Hint: relates to inflammation.)
Inflammation -> increased blood flow to the area + leaky capillaries
46
Compare acute and chronic onset.
``` Acute = abrupt Chronic = long-term ```
47
Both cartilage and bone are types of connective tissue made up of cells embedded in an ECM. List some differences in their traits.
Cartilage: thin, flexible, avascular Bone: strong, rigid, vascular
48
Herbenden’s nodes form on the ___ joints.
Distal
49
List 5 structures found in a synovial joint.
1. Bone 2. Cartilage 3. Synovial fluid 4. Capsule 5. Ligaments
50
What is the name of the envelope surrounding a synovial joint?
Capsule
51
What are tophi?
Deposits of uric acid crystals
52
Uric acid results from the breakdown of which substance?
Purines
53
What is the mortality rate for septic arthritis?
10%
54
Compare passive and active range of movement.
Passive: YOU move the area Active: PATIENT moves the area
55
Compare the cause of osteoarthritis and rheumatoid arthritis.
Osteoarthritis: degenerative | Rheumatoid arthritis: auto-immune
56
Which system of the body triggers inflammation?
Immune system
57
List 3 treatments for osteoarthritis.
1. Painkillers 2. Anti-inflammatory drugs 3. Lose weight
58
Bouchard’s nodes form on the ___ joints.
Medial
59
Which 2 types of joints are most commonly affected by osteoarthritis?
1. High load joints (knees, hips) | 2. Repetitive movement joints (fingers)
60
How does osteoarthritis cause subchondral sclerosis?
Subchondral bone (directly beneath the cartilage) wears down, and the new bone grows back thicker than before
61
List 2 types of nodes that can form on the fingers during osteoarthritis.
1. Bouchard’s nodes | 2. Herbenden’s nodes
62
What are gout crystals made up of?
Uric acid
63
In auto-immune conditions, why does the body attack normal tissue?
Sees it as foreign
64
Which type of investigation would you use to examine synovial fluid?
Joint aspiration
65
List 6 risk factors for gout.
1. Genetic (60%) 2. Obesity 3. Diet – RED MEAT and SEFOOD 4. Alcohol 5. Kidney disease 6. Diuretics
66
What underlying pathology would reduced active range of movement indicate? (Hint: reluctance to cause self pain.)
Damage to joint or surrounding structures
67
How does arthritis cause warmth? (Hint: relates to inflammation.)
Inflammation -> increased blood flow to the area
68
What is the effect of a thickened synovial membrane on volume of synovial fluid produced?
Increased production of synovial fluid
69
What is the most reliable biomarker for rheumatoid arthritis?
Anti-CCP (anti-cyclic citrillunated peptide)
70
List 5 red flags for back pain with a serious underlying cause.
1. Age (<20 or >55) 2. No relief with rest 3. Radiates to chest 4. PMH (cancer, osteoporosis, HIV, etc.) 5. Associated symptoms (sweats, weight loss, fever, etc.)
71
What is the capsule (re: joints)?
Envelope surrounding synovial joints
72
What type of joint would be found between vertebrae?
Fibrocartilaginous
73
What is joint stiffness?
Restricted range of movement
74
What is the most common age group for mechanical back pain?
20-55
75
What is the most rapid and destructive bone disease?
Septic arthritis
76
Why might you order a blood test for arthritis?
To check for biomarkers
77
What would reduced passive range of movement indicate?
Joint damage

Clinical Problem Solving (10 decks)

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