Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

(SG) Phase 2A lectures > msk > Flashcards

msk Flashcards

1
Q

what is rheumatology?

A

medical management of MSK disease (as opposed to surgical approaches)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 2 types of joint pain?

A

inflammatory and non-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some types of inflammatory joint pain?

A

auto-immune
crystal arthritis
infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some non-inflammatory types of joint pain?

A

degenerative eg osteoarthritis

non-degenerative eg fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some types of inflammatory, autoimmune conditions?

A

rheumatoid arthritis
spondylo-arthropathy
connective tissue disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is inflammation?

A

reaction of microcirculation

movement of fluid and WBC into extra-vascular tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does inflammation look like?

A

red (rubor)
painful (dolor)
hot (calor)
swollen (tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how may inflammation present?

A
  • hot, painful, red, swollen joint
  • stiffness
  • poor mobility/function
  • deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the difference in pain in inflammatory vs degenerative disease?

A

inflammatory - pain eases with use

degenerative - pain increases with use, clicks/clunks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is stiffness like in inflammatory vs degenerative disease?

A

inflammatory - stiffness is sign, >60 mins, esp at early morning/evening (rest)

degenerative - not prolonged, <30 mins, morning/evening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is swelling like in inflammatory disease?

A

synovial ± bony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is swelling like in degenerative disease?

A

none, bony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

is inflammatory pain inflamed?

A

yes, hot n red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

is degenerative pain inflamed?

A

not clinically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are pt demographics for inflammatory disease like?

A

young
psoriasis
FHx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are pt demographics for degenerative disease like?

A

older

prior occupation/sport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is joint distribution in inflammatory disease like vs degenerative?

A

inflammatory - hands n feet
degenerative - CMCJ, DIPJ, knees

CMCJ = carpometacarpal joint
DIPJ = distal interphalangeal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does inflammatory n degenerative disease respond to NSAIDs?

A

inflammatory responds

degenerative doesn’t respond as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is asked in an MSK history?

A
  1. where is the pain?
  2. what is the nature of the pain?
  3. is there any stiffness?
  4. is there any swelling?
  5. what is the history of these symptoms?
  6. how has this affected function?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is ?degenerative? bone pain like?

A

at rest and at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is inflammatory joint pain like?

A

pain n stiffness in joints in morning, at rest nd with use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is osteoarthritis pain like?

A

pain on use, at the end of the day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is neuralgic pain like? (neuralgia = nerve pain)

A

pain n paraesthesia in dermatomal distribution, worsened by specific activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is paraesthesia?

A

pins n needles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is referred pain like?

A

unaffected by local movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

which node is at the end of fingertips?

A

heberden’s node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

which node is in the middle/knuckle area of fingertips?

A

Bouchard’s nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what happens w SLE?

A

photosensitivity

mouth ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is a good inflammatory marker?

A

ESR

or CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what does ESR stand for?

A

erythrocyte sedimentation rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the significance of ESR?

A

inflammatory marker

  • rises w inflammation/infection
  • increased fibrinogen = RBCs stick together = fall faster
  • therefore ESR rises
  • ESR rises and falls slowly

so its the rate RBC settle to bottom fo test tube after centrifugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is CRP?

A

acute phase protein

- released in inflammation/infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when is CRP produced?

A

produced in the liver in response to IL-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are auto-antibodies?

A

immunoglobulins that bind to self antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what do u look @ biochemistry-wise with rheumatoid arthritis?

A

RF (rheumatoid factor)

CCP (cyclic citrullinated peptide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what do u look @ biochemistry-wise with SLE?

A

ANA (anti-nuclear antibody)

dsDNA (double stranded DNA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the acronym for features of SpA? (Spondyloarthritis)

A

SPINEACHE

Sausage digit (dactylitis)
Psoriasis
Inflammatory back pain
Nsaid good response
Enthesitis (heel)
Arthritis
Crohns/Colitis/elevated CRP 
Hla B27
Eye (uveitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is enthesitis?

A

inflammation of the entheses (sites where tendons or ligaments insert into the bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is uveitis?

A

inflammation of the uvea — middle layer of the eye that consists of the iris, ciliary body and choroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is axial spondylitis/spondyloarthritis like?

A

bamboo spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how to treat spondylitis?

A

NSAIDs for long-term
physiotherapy
now also: anti-TNF drugs! (works v welllll)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is a hidden site for psoriasis?

A

behind the ear, nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

how do u manage psoriatic arthritis? (PSA)

A

similar to RA

  • early intervention with DMARDs
  • anti TNF drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is reactive arthritis?

A

sterile inflammation of the synovial membrane, tendons and fascia triggered by an infection at a distant site, usually GI / genital

GI eg salmonella, shigella
STI eg chlamydia, ureaplasma urealyticum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what was reactive arthritis formerly known as?

A

reiter’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

when does reactive arthritis usually occur?

A

2d-2w post infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is the investigation for reactive arthritis?

A 
- hot, swollen joint
EXCLUDE septic arthritis and gout
- raised ESR/CRP
- aspirate joint to exclude infection/crystals
- urethral swab, stool culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is enteropathic arthritis?

A

episodic peripheral synovitis that occurs in 1 in 5 IBD patients

  • asymmetric lower limb arthritis
  • usually reflects disease activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

if there’s inflammatory back pain, asymmetrical (large jt arthritis), skin psoriasis, IBD, inflammatory eye disease .. think?

A

spondyloarthritis !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is a normal synovial jt like?

A

2 articulating bone surfaces covered w/ hyaline cartilage
fibrous capsule lined w/ synovium

inflammation of these structures = arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is rheumatoid arthritis a disease of?

A

synovial joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what is RA inflammation like?

A

chronic inflammatory reaction

infiltration of lymphocytes, macrophages, plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is RA proliferation like?

A

tumour like mass “pannus”

grows over articular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is cartilage loss?

A

joint space narrowing caused by loss of cartilage in arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

when cartilage is lost, what happens?

A
  • release of proteinases eg MMPs (matrix metalloproteinases)

- pro inflammatory cytokines eg TNF, IL-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

is RA more common in women or men?

A

2-3x more in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what is an arthropathy?

A

disease of a joint (used regardless of whether there is inflammation or not)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is spondyloarthropathy?

A

any form of arthropathy in vertebral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are symptoms of RA?

A 
joint pain worse in morning
morning stiffness lasts hrs
loss of function
fatigue, malaise
extra-articular involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what causes RA?

A

immunological basis

  • autiantibodies present eg rheumatoid factor
  • immune complexes
  • Ig’s and cytokines in synovial fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

RA can affect extra-articular-soft tissues like?

A

nodules
bursitits
tenosynovitis
muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

how can eyes be impacted w/ RA?

A 
sicca (dry eyes)
corneal ulceration (scleritis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what are lymph nodes n spleen like in RA?

A

lymph nodes may be palpable

spleen may be enlarged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what are some neurological effects of RA?

A

mild, sensory peripheral neuropathy
cervical instability
spinal instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what are some resp impacts of RA?

A

pleural effusion
rheumatoid nodules
small airways disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what are some CVS impacts of RA?

A

pericardial rub
pericarditis
pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

define vasculitis sis

A

inflammation n necrosis of blood vessel with subsequent impaired blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

how can vasculitis be classified?

A

by:

  • size of vessel affected
  • target organ(s)
  • presence/absence of anti-neutrophil cytoplasmic antibodies (ANCA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

how does vasculitis present?

A

no single typical presentation

- systemically unwell, fever, arthritis, rash, weight loss, headache, foot drop, major event eg stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what must be excluded in a vasculitis diagnosis to ensure correct treatment?

A

sepsis, hepatitis
malignancy
other eg cholesterol emboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

name an example of large vessel vasculitis

A

giant cell (temporal) arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

name an example of giant cell (temporal arteritis)

A

granulomatous arteritis of aorta and larger vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

how can giant cell arteritis be treated?

A

prompt corticosteroids

prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is the most common condition affecting synovial joints?

A

osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is OA?

A

age-related, dynamic reaction pattern of a joint in response to insult or injury

all tissues of joint are involved, articular cartilage most affected

76
Q

what is OA mediated by?

A

cytokines (IL-1, TNF-a, NO)

driven by mechanical forces

77
Q

what are the 2 main pathological features of OA?

A

loss of cartilage

disordered bone repair

78
Q

what is the gender bias with OA like?

A

female preponderance

- increased prevalence after menopause

79
Q

what is there a linear relationship btwn OA and?

A

BMI

80
Q

what is obesity, inflammatory wise?

A

a low grade inflammatory state

release of: IL-1, TNF, adipokines (leptin, adiponectin)

81
Q

which occupations are associated with OA?

A

manual labor - OA of small joints of hands
farming - hip OA
footballers - knee OA

82
Q

what are symptoms of OA?

A

pain (may not be present despite X-ray changes) and functional impairment (walking, activities of daily living)

83
Q

what are signs of OA?

A

gait alterations

joint swelling: bony enlargement, effusion, synovitis

84
Q

what are some radiological features of OA? (“MEMORISE THIS”)

JOSSA

A

JOINT SPACE NARROWING

OSTEOPHYTE FORMATION

SUBCHONDRAL SCLEROSIS

SUBCHONDRAL CYSTS

ABNORMALITIES OF BONE CONTOUR

85
Q

what is a good rule of thumb with arthritis?

A

less than 30min joint pain: non inflammatory
more than 60m: likely

exception: fibromyalgia.. not inflammatory but almost all patients have morning stiffness

86
Q

which joints are heberden’s nodes

A

DIP

87
Q

which joints are Bouchard’s nodes?

A

PIP

88
Q

what are the 3 compartments of the knee?

A

medial (inside)
lateral (outside)
patellofemoral (behind kneecap)

89
Q

what is knee locking associated with?

A

loose body in the knee

often bone or cartilage fragment

90
Q

how can OA be managed?

A

non-medically: patient ed, activity, weight loss, physio, footwear, walking aids

pharmacological: topical (NSAIDs), oral (paracetamol), transdermal patches, intra-articular steroid injections
surgical: arthroscopy, osteotomy (realign knees)

91
Q

what are some indications for arthroplasty?

A

uncontrolled pain, esp at night
sig limitation of function
patient age

92
Q

what happens in SLE?

according to diff body symptoms: resp, joints, skin, kidneys, constitutional

A 
resp - pleuritic chest pain
joints - synovitis
skin - rash
kidneys - nephritis
constitutional - fatigue, fever
93
Q

discuss Marfan’s syndrome

A 
tend to be tall
arms longer than height
skeletal abnormalities
concave chest
collagen in blood vessels
94
Q

what is a butterfly rash a medical sign of?

A

lupus

95
Q

what are some clinical features of SLE

A 
fatigue
arthritis
skin rashes
mucosal ulceration
pericarditis
raynaud's phenomenon
venous/arterial thrombosis
96
Q

what is SLE arthritis like?

A

symmetrical
less proliferative than RA
non-erosive

97
Q

anyone w lupus should have regular _____ checks

A

urine…. to see high protein levels/RBC - has lupus affected the kidneys?

98
Q

what is does an abnormal Coombs test mean?

A

positive result means you have antibodies that act against your RBC ://

99
Q

what are some haematological features of SLE?

A

anaemia (haemolytic, Coombs +)
thrombocytopaenia
neutropaenia

100
Q

how do u manage SLE?

A

patient education and support
UV protection
assessment of lupus activity
screening for major organ involvement

101
Q

what is Raynaud’s phenomenon?

A

fingers/toes ache or change colour (pale - blue)

102
Q

how can Raynaud’s be managed?

A

physical protection eg handwarmers
vasodilators eg nifedipine
fluoxetine

103
Q

what is sjogren’s syndrome?

A

disorder of your immune system identified by its 2 most common symptoms — dry eyes & a dry mouth.

condition often accompanies other immune system disorders eg RA and lupus.

104
Q

what are some clinical features of sjogren’s syndrome?

A

dry eyes
dry mouth
arthritis
rash

105
Q

what are important questions to ask in the history of an msk patient?

A

what is your job? (what is he/she exposed to that may be harmful)
tell me what you do (is there anything ant this job that sounds hazardous)

106
Q

what about someone’s job cold be hazardous?

A

harmful exposure to eg dust, fumes etc

does their job involve manual handling? are they using tools that might vibrate?

107
Q

what are the benefits of work?

A 
lower mortality
pay
feelings of accomplishment
social relationships
structure to life
improved fitness
108
Q

when is an illness due to work ?

A

when symptoms improve away from work or on holiday eg occupational asthma

SO when it has been CAUSED BY WORK, OR WORK HAS SUBSTANTIALLY CONTRIBUTED TO THE INJURY

characteristic distriubtion of rash eg contact dermatitis
a cluster of cases in a workplace

109
Q

what are some high risk activities for MSK problems?

A

heavy manual handling
lifting above shoulder weight
incorrect manual handling techniques
fast repetitive work

110
Q

what is the correct way to manually handle (5)

A 
legs apart
feet slightly everted
bend knees rather than back
lift and hold close to trunk
lift ideally from knee height
111
Q

what is the diff btwn tennis n golfer’s elbow

A

tennis - lateral epicondylitis (lots of extension and rotation of the wrist)

golfers - medial epicondylitis (lots of flexion and rotation)

112
Q

what is repetitive strain disorder like?

A

non-specific

often when there’s “unexplained” cramps in the hand

113
Q

in severe cases of carpal tunnel syndrome, u can get what?

A

wasting of the thenar eminence (thenar atrophy)

114
Q

what is carpal tunnel syndrome associated with?

A 
obesity
short stature
pregnancy
OCP
diabetes
hypothyroidism
RA
acromegaly

may be caused by forceful and repetitive work

115
Q

what are some tests for carpal tunnel syndrome? n what is sig abt them?

A

tinel’s
phalen’s

if in either of those tests - u get tingling in median ner

116
Q

GO OVER NERVE DISTRIBUTIONS

A

!

117
Q

what is phalen’s test?

A

back of hands facing each other weird thing

occurs when the median nerve is compressed or squeezed at the wrist.

118
Q

what is tinel’s sign (test) like ?

A

performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve

119
Q

what is a cause of secondary Raynaud’s phenomenon?

A

hand-arm vibration syndrome

120
Q

how can we distinguish white fingers?

A

primary raynaud’s

other types of secondary raynaud’s

121
Q

what is tenosynovitis caused by

A

inflammation of APL and EPB tendon-sheath

122
Q

how can tenosynovitis be treated?

A

NSAIDs
steroid injection
rest

123
Q

what is tenosynovitis?

A

inflammation of synovial that surrounds a tendon - typically leading to joint pain/swelling/stiffness

124
Q

what are the 2 types of epicondylitis?

A 
tennis players (lateral)
golfers (medial)
125
Q

what is epicondylitis associated with?

A

forceful flexion-extension of wrist/forceful pronation-supination

126
Q

what is repetitive strain disorder?

A

non-specific pain in the hand

127
Q

what do rotator cuff problems usually affect?

A

supraspinatus tendon

or shoulder impingement/osteoarthritis of acriomicoclavicular joint

128
Q

what is thoracic outlet syndrome?

A

pain/tingling down or blanching of fingers related to posture of arm

because of: compression of trunks of brachial plexus/subclavian artery in neck under clavicle

129
Q

what is thoracic outlet syndrome associated with?

A

poor posture or loading of shoulders

130
Q

what is OA of hip associated with?

A

CDH (Congenital Diaphragmatic Hernia?)
slipped epiphyses
perthe’s disease

obesity, trauma and menisectomy

131
Q

how do you get a patient back to work?

A

are there any barriers?
footnotes
rehab - phased return, restricted duties

132
Q

what is mechanical back pain associated with?

A

manual handling
twisting while lifting
smoking

133
Q

if u have a joint that might be infected, what is the only way to find out?

A

joint aspiration !!!!

blood cultures

134
Q

what is joint aspirate like?

A

no logturgid fluid
leucocytes ++
gram stain + cocci

135
Q

what is infected joint aspirate like?

A

no longer see through
yellow
pus-y
meant to be yellow, see through, light viscosity

136
Q

what is staphylococcus aureus sensitive to?

A

flucloxacillin
erythromycin
doxy/tetracycline

137
Q

with a flare of RA, u might expect CRP up to 100; If this high, suspect what?

A

infection

138
Q

what are some risk factors for septic joint?

A 
any cause for bacteraemia
direct/penetrating trauma
local skin ulcers
damaged joints
immunosuppression
139
Q

what is a typical clinical presentation of a septic joint?

A

painful, red, swollen, hot joint
fever
90% mono arthritis
knee > hip > shoulder

140
Q

how do u manage a septic joint?

A

aspiration !!!

ABs, joint washout, analgesia

141
Q

what is the commonest infecting organism overall?

A

staphylococcus aureus

142
Q

what is ESR?

A

erythrocyte sedimentation rate
blood test
done to check for diseases causing inflammation

143
Q

what is ESR aka

A

sedimentation rate

sed rate

144
Q

what is osteomyelitis?

A

infection localised to bone

145
Q

what is arthroplasty?

A

surgical reconstruction/replacement of a joint

146
Q

what are some symptoms of MSK tumours?

A

pain, swelling, erythema
limp/loss of use of limb
failure to thrive
pyrexia, raised WCC

147
Q

what is pyrexia?

A

temp

148
Q

what is erythema?

A

redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries.

occurs with any skin injury, infection, or inflammation.

149
Q

what are lab tests for MSK tumours like

A

often non-specific but consider PSA, ESR/CRP

150
Q

what is MSK exam like ?

A 
look
feel
move
special test
examine joint proximal n distal
general/neuro exam
151
Q

name some different fracture patterns

A 
transverse
oblique
spiral 
butterfly
comminution
segmental
152
Q

what are the 3 principles of treatment?

A

reduce
hold
rehabilitate

153
Q

what is a crystal?

A

homogenous solid

stable, hard, high density

154
Q

what does deposition of crystals result in?

A

local inflammatory response

tissue damage

155
Q

what is crystal arthropathy?

A

arthritis caused by crystal deposition in joint lining

156
Q

what is the diff btwn gout and pseudo gout?

A

gout = urate crystals

pseudo gout = pyrophosphate crystals

157
Q

what crystals are in gout?

A

urate

158
Q

what crystals are in pseudo gout?

A

pyrophosphate crystals

159
Q

how does crystal arthropathy present?

A

acutely with hot, swollen joints

chronically with longer term damage

160
Q

how is crystal arthropathy diagnosed?

A

history
pattern
aspiration of joint to look for crystals
blood tests/XRs

161
Q

what is a gout attack?

A

acute inflammation

162
Q

what is diff btwn acute inflammation n LT deposition in gout?

A 
acute = gouty arthritis, gout attack
LT = tophaceous gout
163
Q

how does gout happen?

A

uric acid - prod from purines/nucleic acids

key enzyme: xanthine oxidase

164
Q

how do purines go to gout?

A

purines - hypoxanthine - xanthine - uric acid - monosodium urate

165
Q

what is the path of gout?

A

renal, diet, drugs –> excessive urate –> urate crystals –> phagocyte activation –> inflammation

166
Q

whats hyperuricaemia a major risk factor for?

A

gout

167
Q

what is SUA

A

serum uric acid

168
Q

what is a precipitant?

A

cause of a particular action/event

169
Q

what are common precipitants of uric acid conc incr?

A

alcohol/shellfish binges
sepsis
MI/trauma

170
Q

what causes pseudo gout?

A

deposition of calcium pyrophosphate crystals on joint surface

crystals elicit acute inflammatory response

171
Q

what are some clinical features of pseudo gout?

A 
incidental finding on radiology
acute synovitis (severe pain/stiffness, fever)
172
Q

what can trigger an acute attack of pseudo gout?

A

direct trauma
surgery
blood transfusion

173
Q

how do u manage pseudo gout?

A

acute: NSAIDs, analgesia, aspiration, physio
LT: surgery, anti rheumatics

174
Q

define osteoporosis

A

a systemic skeletal disease characterised by LOW BONE MASS and MICROARCHITECTURAL DETERIORATION of bone tissue with a consequent increase in BONE FRAGILITY/SUSCEPTIBILITY TO FRACTURE

175
Q

what is the bone remodelling cycle?

A

quiescence - resorption - formation - quiescence

176
Q

why does postmenopausal OA happen?

A

loss of restraining effects of oestrogen on bone turnover

177
Q

how can postmenopausal OA be prevented?

A

oestrogen replacement

178
Q

what is high bone turnover?

A

resorption > formation

179
Q

how is postmenopausal OA characteriseD?

A

high bone turnover

predominantly cancellous bone loss- -

180
Q

how does trabecular architecture change with age?

A

decrease n trabecular thickness
decrease in connections btwn horizontal trabecular
decrease in trabecular strength/increased susceptibility to fracture

181
Q

what are some risk factors for inflammatory disease?

A

rheumatoid arthritis
connective tissue disease
IBD

182
Q

which hormones influence bone turnover?

A

thyroid hormone/PTH increase bone turnover
cortisol increases bone resorption/induces osteoblast apoptosis
oestrogen/testosterone control bone turnover

183
Q

how can drugs treat osteoporosis?

A

anti-resorptive - decrease osteoclast activity and bone turnover
anabolic - increase osteoblast activity and bone formation

184
Q

what are the benefits of HRT

A

educe risk of fractures by 50%
stop bone loss; density may increase by 10%
prevents hot flushes/other menopausal symptoms
reduces colon cancer risk

185
Q

what is a DEXA scan?

A

special type of X-ray that measures bone mineral density (BMD)

186
Q

what does a DXA scan measure

A

BMD

187
Q

define osteophyte

A

a bony projection associated with the degeneration of cartilage at joints

(SG) Phase 2A lectures (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions