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Y5 > MSK > Flashcards

MSK Flashcards

1
Q

Main risk factors of Osteoporosis

A

Female (post menopause)
Low BMI
Long term steroids (inc cushings)

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2
Q

Dx osteoporosis

A

FRAX score
DEXA scan

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3
Q

T scores for DEXA scan

A

> -1 Normal
-1 to 2.5 osteopenia
<2.5 osteoporosis

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4
Q

Components of FRAX score

A

TFT
Bone profile
Bone turnover (CTX)

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5
Q

Mx osteoporosis

A

Conservative

Bisphosphonates (alendronates SEs GORD + osteonecrosis of jaw) Take on empty stomach, sit upright, wait 30 mins before eating.

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6
Q

Features of OA on XRay

A

Cyst formation
Osteophyte formation on joint edge
Narrowing of joint space
Sclerosis of subchondral bone

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7
Q

Mx OA

A

Conservative, weight loss + physio
1st - analgesia, topical nsaid + paracetamol
2nd - Oral NSAIDs + PPI + topical capsaicin
IA corticosteroids
Partial/total joint replacement

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8
Q

Risk factors of RA

A

Female, Family history (HLA DR4)

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9
Q

RA Dx

A

Rheumatoid factor (Present 70%)
anti-CCP antibodies (more specific)

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10
Q

Ix RA

A

Disease activity score (>5.5 need for biologics -mabs)
Normocytic anaemia of chronic disease
ESR/CRP elevated

Joint XR
Subluxation
Osteoporosis juxta articular
Loss of joint space
Erosions of periarticular space

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11
Q

RA Mx

A

Smoking cessation
Acute flare, NSAIDS + PPI
Glucocorticoids/sterois IM methylprednisolone

Chronic maintenance
1. Methotrexate
Sulfalazine
Hydroxychloriquine
Anti-TNF drugs (e.g. infliximab)

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12
Q

Commonest organisms in SA

A

Overall Staph aureus
young adults Neisseria gonhorroea
Children Strep pneumoniae or H influenza

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13
Q

Ix SA

A

Aspirate
MC&S
Crystal microscopy

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14
Q

Mx SA

A

Washout
IV Abx 2g fluclox QDS 2 wks
PO Abx for 4 weeks

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15
Q

Features of Gout

A

Monosodium Urate monohydrate crystals
Chronic hyperuricaemia (uric acid)

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16
Q

IX Gout

A

Serum uric acid raised
Punched out lesions on XRay
Joint aspirate gold standard (Crystals, negative birefringent needle shaped)

17
Q

Mx Gout

A

Acute flare
- Diclofenac
- Colchicine (if renal impaired)
- Steroid IA

Chronic
- Allopurinol (only after flare subsided)
- Lifestyle

18
Q

Features pseudogout

A

Calcium pyrophosphate crystals
Risks, inc calcium, hyperparathyroidism

19
Q

Ix Pseudogout

A

Chondrocalcinosis on Xray
Joint aspirate
- Rhomboid shaped crystals, positive birefringent

20
Q

Henloch Schonlein Purpura

A

IgA vasculitis
Purpuric rash LL or buttocks in kids
Joint pain
Abdo pain
Renal (IgA nephritis)

21
Q

REactive arthritis

A

Synovitis due to infective trigger
Cant see, pee, climb a tree
Bilateral conjunctivitis, balanitis, reactive arthritis

Abx until Septic A excluded
- NSAIDS
- Steroids
- Sulfalazine

22
Q

Ankylosing Spondylitis

A

Affects vertebral column and sacroiliac
Progressive stiffening > fusion
Male young adults, pain and stiffness in lower back

23
Q

Syndesmophytes

A

Calcification of ligament structures e.g. discs

Y5 (11 decks)

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