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Flashcards in Joint disease Deck (22)
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1

What is the role of osteoblasts?

Build new bone

2

What is the role of osteoclasts?

Break down old bone

3

What is osteoporosis caused by?

An imbalance of osteoblast and osteoclast levels.
Reduced osteoblast activity and increased osteoclast activity leading to low bone mass

4

What is the first sign/symptom of osteoporosis?

Fracture

5

How is bone mass density determined?

DXA scan

6

DXA scans usually measure bone density at hip/lower back to get a T score. What score is indicative of osteoporosis?

Score less than or equal to 2.5

7

What is the pathogenesis of osteoarthritis?

Cartilage gradually roughens and becomes thin.
Thickening of underlying bone
Formation of osteophytes
Thickening and inflammation of synovium
Thickening and contraction of ligament

8

What are some of the non-pharmacological management options for osteoarthritis?

Weight reduction
Physiotherapy
Exercise plan
Heat packs

9

What are some of the pharmacological management options for osteoarthritis?

Simple analgesics
NSAIDs
Corticosteroids

10

What is the difference between osteoarthritis and rheumatoid arthritis?

Osteoarthritis usually affects one joint only whereas rheumatoid is more systemic and affects multiple joints

11

Why is there a likely reduced life expectancy in rheumatoid arthritis?

Due to risk of developing other diseases e.g. CVD

12

Early morning stiffness is more common in osteoarthritis rather than rheumatoid arthritis. True or false?

False

13

What is the pathogenesis of rheumatoid arthritis?

Lymphocytes infiltrate the synovial membrane, causing inflammation and thickening
Formation of pannus over cartilage causes erosion into bone
Eventual degeneration of cartilage joint

14

DMARDs are used in the management of which joint disease?

Rheumatoid arthritis

15

Why do women have accelerated bone loss around menopause?

Because of the loss of the protective effect of oestrogen - due to decreased levels

16

How can peak bone mass be optimised?

By having healthy balanced diet and doing weight bearing exercises e.g. aerobics and running early on in life

17

List 6 risk factors for developing osteoporosis?

Smoking
Oestrogen deficiency
History of fractures
Increasing age
Female
Excess alcohol consumption
History of fracture in first degree relative
Corticosteroid use

18

What are the pre-screening checks before starting biologic DMARDs?

FBC
LFT
TB
HIV/Hep A/B
Diabetes
MS
History of heart disease

19

Which cDMARD doesn't require regular blood monitoring?

Hydroxychloroquine

20

Which cDMARD causes urine discolouration?

Sulfasalazine

21

Which cDMARD requires folic acid?

Methotrexate as it is a folate antagonist

22

Which drugs can cause skin rash?

Hydroxychloroquine and sulfasalazine