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LS locomotor > locomotoro > Flashcards

locomotoro Flashcards

1
Q

what is the most common locomotor condition?

A

osteoarthritis

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2
Q

how does it differ from RA?

A

OA is a degenerative condition from wear and tear over the years whereas RA is AI

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3
Q

who does it affect

A 
F:m 3:1 
Over 50s
those who have had previous injury
wear and tear-overuse from job
obesity
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4
Q

define osteoarthritis

A

degenerative condition where cartiladge becomes damaged and worn
there is the formation of osteophytes
often inflamed and tender on palpation

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5
Q

signs and symptoms

A 
pain on movement
background rest pain
worse at night
inactivity of 30 mins can cause joints to jel
crepitus on movement
hebeden and bouchards node 
reduced range of movement
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6
Q

commonly affected sites

A 
cervical and lumbar spine
knee 
foot MTP
hand- DIP PIP
hip
often asymmetrical
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7
Q

investigations

A

XRAY-LOS loss of JOINT SPACE , osteophytes, subarticular scleross
Elevated CRP

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8
Q

Management

A 
exercises and physiotherapy
pain relief-nsaids, coedeine
weight loss
intraarticular steroid injections 
heat packs, walking aids 
TENS
surgery-joint replacement
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9
Q

DD

A

bursitis
gout
psueogout

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10
Q

who does RA affect?

A

2:1 F:m
5-6th decade
more common in smokers
genetic tendency -HLA-DR4/1

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11
Q

what is it?

A

autoimmune progressive disorder of the joints-often presents symmetrically - autoantibodies against the synovial joints
the synovial membrane becomes inflammated and infilterated with lymphocytes - forming a plaque on te cartiladge known as PANNUS

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12
Q

presents

A

inflammation and pain in small joints
symmetrical distribution
pain worse in morning and stiffeness worse at rest
signs- boutinneres , swan neck deformities
ulnar deviation/subuxaltion of joints

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13
Q

boutinneres and swan neck deformities -difference between them

A

boutinneres- fixed flexion of PIP

swan neck deformities- fixed hyperextension of PIP

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14
Q

diagnostic criteria

A 
4 of the 7 of the following 
- rheumatoid nodule
-rheumatoid factor +
- 3 or more joints involved 
- hand joint involvement
radiograph changes 
-symmetrical
 -morning stiffness for 6  or more weeks over an hour
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15
Q

areas affected

A

wrist, below, knee, shoulder, ankle

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16
Q

3 key descriptives

A

swollen, stiffiness and warm

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17
Q

investigations

A

clinical examination
rheumatoid factor present In 70%
anti-CRP antibody
Xray shows- swelling, osteopenia, redcued joint space, subulaxtion

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18
Q

management

A

1st line- DMARDS - Ciclopsorin methotrexate
biologics -▪abatacept
▪rituximab
▪tocilizumab.

surgery
Sulfasazmine
•leflunomide

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19
Q

what is gout?

A

gout is a monoarthropathy caused by a build up in sodium urate crystals
seen with severe inflammation

20
Q

where do most occur

A

60% ATJ of big toe

21
Q

risk factors and causes

A 
increased dietary purines
alcohol
diuretics 
leukemia 
renal impairment 
infection
trauma
surgery
22
Q

associations

A

indicator of disease:
hypertension
IHD
Diabetes

23
Q

investigations

A

polarised light microscopy
Xray -radiographs
bloods- ESR , urate
synovial fluid - urate crystals

24
Q

treatment

A 
nsaids
steroids
clochines 
allopurinol
ice pack
rest and elevate
25
Q

septic arthritis

A

inflammation of joint caused by infection

26
Q

presentation

A

single swllen joint with pain on active/passive movement
chest wall pain if joints such as sternoclavicular affect
fever
rigors

27
Q

signs

A

bacteriaema
may present as hypotension and vomiting
abscess at joint site

28
Q

causes

A

s.aureus

streptococci

29
Q

investigations

A

joint aspiration

cultures

30
Q

rf

A 
Pre-existing joint disease
immonosupression
diabetes 
joint surgery
chronic renal ailure
over 80 yars of age 
IV drug use 
prosthetic joints
31
Q

differentials

A

OA, RA

32
Q

investigations

A

joint aspiration

blood cultures

33
Q

treatment

A

cause dependent

fluxoacillin
vancomycin

nsaids, ice pack, rest
refer if prosthetic joint affected

34
Q

what is slipped prolapsed disc?

A

when the NUCLEUS PULPOSUS buldges through a weakness in fibrous outer ring of disc and may put pressure on nearby structures or become inflamed.

35
Q

symptoms

A 
back pain - severe, sudden onset eased by lying flat, worse on movement and cough or sneezing 
pins and needles
numbness or weakess in buttons 
leg food or neck pain 
bladder and bowel malfunction 
sadle anaethestia
36
Q

test

A

raise leg of pt

patiet between 3o and 70 degrees

37
Q

who

A

M> F

30-50 year olds

38
Q

risk factors s

A

weight lifting
strenuous job involing lots of lifting
smoking

obesity
age
sitting a lot

39
Q

treatment

A

exercise
pain relief
surgery-disecktomy
diazepam

40
Q

investigations

A

xray

MRI

41
Q

Define osteoporsis

A

It is the weakening of bone can lead to loss of bone

Defined as decreased bone mass + deranged bone micro architecture = failure of structural integrity

42
Q

Common site of fractures

A

Spine
Neck of femur
Wrist

43
Q

Causes and risk factors

A 
Women  esp post menopause 
Increasing age 
Hyperthyroidism
Cushing syndrome 
Malabsorption condition such as ibd coeliac 
Myeloma
Ckd 
Diabetes 
Medications such as corticosteroids , heparin, 
Hysterectomy
44
Q

Investigations

A 
Dexa scan
Calcium and bone profile 
Vitamin d 
Frax score 
T scores less than -2.5
45
Q

TreAtment

A

Bisphosphates such as alendronic acid and zolendronic acid

Non bisphosphates- denosumab terparatide
Testosterone  in men
HRT
calcium and vitamin d supplements
Strontium ranelate
46
Q

What is teriparatide

A

Parathyroid hormone

LS locomotor (2 decks)

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