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Flashcards in Diseases of MSK 1 Deck (54):
1

The group of diseases causing pain, stiffness and inflammation of the MSK system

Arthritides

2

2 different types of arthritides

Acute and Chronic

3

2 different types of chronic arthritis

Osteoarthritis
Rheumatoid arthritis

4

Commoneste type of joint disease aka degenerative joint disease, Progressive erosion of articular cartilage.

Osteoarthritis

5

What forms at the margins of joints in osteoarthritis

Bony spurs and cysts

6

Underlying systemic diseases in OA

Diabetes
Obesity

7

Which joints are affected by OA in men and women?

Men-hip
Women- knees and hands

8

Pathogenesis of OA

Deterioration or loss of cartilage
Bone forms spurs and cysts
Results in pain and limitaiton of movements

9

Cells which form the cartilage around bone

Chondrocytes

10

How do chondrocytes contribute to OA

-Produce interleukin 1- initiates matrix breakdown. -Prostaglandin derivative induces the release of lytic enzymess- prevents matrix synthesis

11

Abnormal stresses in weight bearing joints

Primary OA

12

What joints are commonly affected in OA

Fingers, knees and cervical and lumbar spines

13

What forms in the fingers in primary OA

Herbeden's or Bouchard's nodes

14

Chronic systemic disorder-principally affecting the joints

Rheumatoid arthritis

15

Pathogenesis of RB

Production of a non suppurative proliferative synovitis-destruction of articular cartilage and ankylosis of joints

16

Who is more at risk of RA- emn or women?

Women

17

What happens to the synovium in RB

Polypoid fibrovascular thickening of the synovium, forms a pannus that invades into the articular cartilage- penetrates subchondral bone and cyst formation

18

Clinical features of RB

Malaise, fatigue and generalised MSK pain
Joints are swollen, warm, painful and stiff in the morning or after activity
Small joints of the hands and feet are frequently affected

19

Mutations in which genes predispose you to RA

HLA
DR4
DR1

20

Name 2 primary exogenous arthritogens

EBV
Borrelia

21

Describe the pathogenesis of RA

Autoimmune reaction within the synovial membranes- CD4 positive T cells.
Release of cytokines- IL1,6, TNF alpha and beta

22

Criteria for diagnosis

Morning stiffness
Arthritis in 3 or more joint areas
Arthritis of hand joints
Symmetric arthritis
Rheumatoid nodules
Serum Rheumatoid factor
Typical radiographic changes-narrowing of joint space, loss of articular cartilage

23

What 2 main things are required for the diagnosis of RB

Rheumatoid factor- present in most
Analysis of synovial fluid- presence of neutrophils

24

RA- other systems involvement

Skin- rheumatoid nodules
Lung, spleen, heart and other viscera

25

What do you call arthitis which lacks rheumatoid factor

Sero-negative arthritides

26

4 sero negative arthritides

Ankylosing spondylitis
Reiter's syndrome
Psoriatic arthritis
Enteropathic arthritis

27

End point of a group of disorders producing hyperuricaemia- uric acid is the end product of purine metabolism

Gout

28

4 clinical features of gout

Acute arthritis
Chronic arthritis
Tophi in various sites
Gouty nephropathy

29

Pathogenesis of gout

Transient attacks of acute arthritis- crystallization of urates within and about joints, leading to chronic gouty arthritis and deposition of masses of urates in joints and other sites - tophi

30

deposition of masses of urates in joints and other sites

Tophi

31

Sytemic illness and marked pain over the affected region is typical of what condition?

Pyogenic (bacterial) osteomyelitis

32

What shows up on the X-ray for pyogenic osteomyelitis

Lytic focus of bone destruction surrounded by zone of sclerosis

33

3 mechanisms of cause of pyogenic osteomyelitis

Haematogenous
Contiguous
Direct implantation

34

Acutely painful and swollen joints with restricted movements, with fever, leucocytosis and elevated ESR

Infective arthritis

35

Common bacterial causes of infective arthritis

Staph, strep, gonococcus, mycobacteria

36

Predisposing conditions for infective arthritis

Trauma
IVDU
debilitating illness

37

What are the d2 types of osteoporosis

Primary or secondary

38

Primary osteoporosis risk factors

Age and postmenopausal

39

Increased porosity of the skeleton, reduction in bone mass, localised or entire skeleton

Osteoporosis

40

3 clinical features of osteoporosis

Vertebral fractures
Kyphosis
Scoliosis

41

3 causes of secondary osteoporosis

Endocrine disorders
neoplasm e.g. multiple myeloma
Malnutrition

42

2 examples of ednocrine disorders that predispose you to secondary osteoporosis

Hyperparathyroidism, Type 1 diabetes

43

Paget's disease

Osteoclast dysfunction- matrix madness. Histological hallmark-mosaic pattern

44

Cause of paget's disease

Paramyxovirus

45

Pathogeneisis of osteoclast dysfunction e.g. paget's disease

Pred. osteoblastic activity- gain in bone mass. Newly formed bone is disordered and architecturally unsound

46

Who is most at risk of Paget's disease

5th decade, males

47

What bones are most commonly affected by paget's disease

Axial skeleton and proximal skeleton

48

Most common symptom of pagets

Pain

49

What type of fractures do you get in Paget's disease?

Chalk stick type fractures

50

3 causes of paget's disease

Giant cell tumour- benign
Malignant-osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma

51

Defects in matrix mineralisation, related to lack of vit. D.

Ostomalacia

52

Decreased bone density

Osteopenia

53

Are skeletal deformities seen in osteomalacia?

No

54

Excessive secretion of parathyroid hormone

Hyperparathyroidism