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Clinical Pathology > Diseases of MSK 1 > Flashcards

Diseases of MSK 1 Flashcards

1
Q

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

A

Arthritides

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2
Q

2 different types of arthritides

A

Acute and Chronic

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3
Q

2 different types of chronic arthritis

A

Osteoarthritis

Rheumatoid arthritis

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4
Q

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

A

Osteoarthritis

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5
Q

What forms at the margins of joints in osteoarthritis

A

Bony spurs and cysts

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6
Q

Underlying systemic diseases in OA

A

Diabetes

Obesity

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7
Q

Which joints are affected by OA in men and women?

A

Men-hip

Women- knees and hands

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8
Q

Pathogenesis of OA

A

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

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9
Q

Cells which form the cartilage around bone

A

Chondrocytes

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10
Q

How do chondrocytes contribute to OA

A

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

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11
Q

Abnormal stresses in weight bearing joints

A

Primary OA

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12
Q

What joints are commonly affected in OA

A

Fingers, knees and cervical and lumbar spines

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13
Q

What forms in the fingers in primary OA

A

Herbeden’s or Bouchard’s nodes

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14
Q

Chronic systemic disorder-principally affecting the joints

A

Rheumatoid arthritis

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15
Q

Pathogenesis of RB

A

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

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16
Q

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

A

Women

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17
Q

What happens to the synovium in RB

A

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

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18
Q

Clinical features of RB

A

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

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19
Q

Mutations in which genes predispose you to RA

A

HLA
DR4
DR1

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20
Q

Name 2 primary exogenous arthritogens

A

EBV

Borrelia

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21
Q

Describe the pathogenesis of RA

A

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

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22
Q

Criteria for diagnosis

A 
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
Q

What 2 main things are required for the diagnosis of RB

A

Rheumatoid factor- present in most

Analysis of synovial fluid- presence of neutrophils

24
Q

RA- other systems involvement

A

Skin- rheumatoid nodules

Lung, spleen, heart and other viscera

25
Q

What do you call arthitis which lacks rheumatoid factor

A

Sero-negative arthritides

26
Q

4 sero negative arthritides

A

Ankylosing spondylitis
Reiter’s syndrome
Psoriatic arthritis
Enteropathic arthritis

27
Q

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

A

Gout

28
Q

4 clinical features of gout

A

Acute arthritis
Chronic arthritis
Tophi in various sites
Gouty nephropathy

29
Q

Pathogenesis of gout

A

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
Q

deposition of masses of urates in joints and other sites

A

Tophi

31
Q

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

A

Pyogenic (bacterial) osteomyelitis

32
Q

What shows up on the X-ray for pyogenic osteomyelitis

A

Lytic focus of bone destruction surrounded by zone of sclerosis

33
Q

3 mechanisms of cause of pyogenic osteomyelitis

A

Haematogenous
Contiguous
Direct implantation

34
Q

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

A

Infective arthritis

35
Q

Common bacterial causes of infective arthritis

A

Staph, strep, gonococcus, mycobacteria

36
Q

Predisposing conditions for infective arthritis

A

Trauma
IVDU
debilitating illness

37
Q

What are the d2 types of osteoporosis

A

Primary or secondary

38
Q

Primary osteoporosis risk factors

A

Age and postmenopausal

39
Q

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

A

Osteoporosis

40
Q

3 clinical features of osteoporosis

A

Vertebral fractures
Kyphosis
Scoliosis

41
Q

3 causes of secondary osteoporosis

A

Endocrine disorders
neoplasm e.g. multiple myeloma
Malnutrition

42
Q

2 examples of ednocrine disorders that predispose you to secondary osteoporosis

A

Hyperparathyroidism, Type 1 diabetes

43
Q

Paget’s disease

A

Osteoclast dysfunction- matrix madness. Histological hallmark-mosaic pattern

44
Q

Cause of paget’s disease

A

Paramyxovirus

45
Q

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

A

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

46
Q

Who is most at risk of Paget’s disease

A

5th decade, males

47
Q

What bones are most commonly affected by paget’s disease

A

Axial skeleton and proximal skeleton

48
Q

Most common symptom of pagets

A

Pain

49
Q

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

A

Chalk stick type fractures

50
Q

3 causes of paget’s disease

A

Giant cell tumour- benign

Malignant-osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma

51
Q

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

A

Ostomalacia

52
Q

Decreased bone density

A

Osteopenia

53
Q

Are skeletal deformities seen in osteomalacia?

A

No

54
Q

Excessive secretion of parathyroid hormone

A

Hyperparathyroidism

Clinical Pathology (53 decks)

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