CBL cards 2

Question 1

“Pathogenesis and Pathological Changes in RA”

Answer 1

Autoimmune disorder, Synovial inflammation and hyperplasia, Formation of pannus (inflammatory tissue) eroding cartilage and bone, Destruction of articular structures, Systemic manifestations including rheumatoid nodules\

Question 2

Investigations for RA Diagnosis

Answer 2

Rheumatoid factor (RF), Anti-cyclic citrullinated peptide (anti-CCP) antibodies, Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), Imaging (X-ray, ultrasound, MRI), Synovial fluid analysis (for inflammatory markers)\

Question 3

Management of RA

Answer 3

Multidisciplinary team (MDT) involvement (rheumatologist, physiotherapist, occupational therapist), Disease-modifying antirheumatic drugs (DMARDs) - methotrexate, sulfasalazine, biologic agents, Nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief, Corticosteroids for acute flares, Physical therapy and exercise\

Question 4

Relationship Between Psoriasis and Joint Disease

Answer 4

Psoriatic arthritis (PsA) is a common manifestation, Both conditions share underlying immune dysregulation and genetic predisposition\

Question 5

Signs and Symptoms of Seronegative Spondyloarthropathies

Answer 5

Inflammatory back pain, Enthesitis (inflammation at tendon or ligament insertion points), Peripheral arthritis, Extra-articular manifestations (e.g., uveitis, psoriasis, inflammatory bowel disease)\

Question 6

HLA B27 and Seronegative Spondyloarthropathies

Answer 6

Genetic marker associated with increased risk, Presence in many individuals with seronegative spondyloarthropathies, Exact role in disease pathogenesis not fully understood\

Question 7

Dermatological Features of Psoriasis

Answer 7

Red/Violaceous, scaly plaques with well-defined borders, Commonly found on extensor surfaces (elbows, knees), scalp, and nails, Auspitz sign (pinpoint bleeding when scales are removed)\

Question 8

Treatment Options for Psoriasis

Answer 8

Topical corticosteroids, Topical vitamin D analogs, Phototherapy (UVB, PUVA), Systemic agents (methotrexate, cyclosporine, biologics\

Question 9

Causes of Vitamin D Deficiency

Answer 9

Inadequate sunlight exposure, Poor dietary intake, Malabsorption disorders, Renal dysfunction, Altered metabolism due to medications or liver disease\

Question 10

Clinical Features of Osteomalacia

Answer 10

Bone pain and tenderness, Muscle weakness and fatigue, Fractures (especially in weight-bearing bones)\

Question 11

Calcium and Phosphate Homeostasis

Answer 11

Regulated by parathyroid hormone (PTH), calcitonin, and vitamin D, PTH increases serum calcium by stimulating bone resorption and renal reabsorption, Vitamin D promotes intestinal absorption of calcium and phosphate\

Question 12

Pathology, Investigation, and Management of Osteomalacia

Answer 12

Histological evidence of undermineralized bone on bone biopsy, Blood tests showing low serum calcium and phosphate, elevated alkaline phosphatase, Treatment involves correcting underlying cause and vitamin D supplementation\

Question 13

Red Flags in Clinical Presentation for Back Pain

Answer 13

History of trauma, Age >50 or <20 years, History of cancer, Constitutional symptoms (fever, weight loss), Neurological deficits or bowel/bladder dysfunction\

Question 14

A-E Assessment of Acutely Unwell Patient

Answer 14

Airway assessment, Breathing assessment, Circulation assessment, Disability assessment (neurological), Exposure (undressing for full examination)\

Question 15

Compartment Syndrome

Answer 15

Increased pressure within a closed anatomical compartment impairs circulation and tissue perfusion, Common in limbs, particularly lower leg and forearm, Leads to ischemia, tissue necrosis, and nerve damage if untreated\

Question 16

Management of Compartment Syndrome

Answer 16

Urgent fasciotomy (surgical decompression), Continuous monitoring of compartment pressures, Prevention of complications like infection and contractures\

Question 17

Complications of Fractures

Answer 17

Soft tissue injury (contusions, lacerations), Vascular injury leading to ischemia or hemorrhage, Compartment syndrome due to increased pressure within a compartment\

Question 18

Symptoms and Signs of Acute Limb Ischaemia

Answer 18

Sudden onset severe pain, Pallor, Pulselessness, Paresthesia, Paralysis, Flexion of the compartment causes pain as pressure increases\

Question 19

Terminology for Describing Fractures

Answer 19

Type (e.g., transverse, oblique, comminuted), Location (e.g., proximal, distal, shaft), Alignment (e.g., displaced, non-displaced), Open or closed (compound or simple)\

Question 20

Missed Diagnoses and Medical Errors

Answer 20

Lack of thorough history-taking or examination, Misinterpretation of test results, Confirmation bias or anchoring, Communication errors between healthcare providers\

Question 21

Impact of Migrant Journeys on Health Access

Answer 21

Language and cultural barriers, Limited access to healthcare facilities during migration, Trauma and stress affecting physical and mental health, Legal and social factors influencing access to healthcare services\