Musculoskeletal and Connective Tissue Disorders

Question 1

What are the 3 main bone diseases?

Answer 1

Arthritis
Arthritis
Arthralgia

Question 2

What is arthritis?

Answer 2

Inflammation of the joints

Question 3

What is arthrosis?

Answer 3

Non inflammatory bone disease

Question 4

What is arthralgia?

Answer 4

Joint pain

Question 5

What is bone?

Answer 5

Mineralised connective tissues

Question 6

What 3 things would you find in bone?

Answer 6

Calcium
Phosphate
Vitamin D

Question 7

What happens during the turnover cycle?

Answer 7

1. Bone removed by osteoclasts
2. Bone deposited by osteoblasts
3. Osteoclasts eat matrix
4. Matrix replaced by osteaoblats
5. Mineralised

Question 8

How long does turnover cycle last?

Answer 8

3-6 months

Question 9

What is calcium involved in that makes it important to keep it in the blood?

Answer 9

Nerve function

Question 10

What does the parathyroid hormone do in regards to bone?

Answer 10

Maines calcium level and increased calcium release from bone

Question 11

What do hyperparathyroidism and hypoparathyroidism cause?

Answer 11

Increased bone reabsorption

Question 12

Where does vitamin D get processed?

Answer 12

In the blood and liver

Question 13

What is oestomalacia?

Answer 13

Poorly mineralised osteoid matrix and cartilage growth plage

Question 14

What is oestroporsis?

Answer 14

Reduced bone mass

Question 15

What causes oestomalakia?

Answer 15

Calcium deficiency

Question 16

Symptoms of oestomalakia/ rickets ?

Answer 16

Sore legs to touch
Muscle weakness
Facial twitching
Bow legs

Question 17

What is the management of lack of vitamin D?

Answer 17

Sunlight exposure 30 mins x 5 weekly
Diet

Question 18

What are the risk factors of oestoprosis?

Answer 18

Age
Female
Hormone deficiency

Question 19

What age is peak bone mass?

Answer 19

24-35

Question 20

What are the effects of bone mass loss?

Answer 20

Fracture risk
Height loss
Kyphosis + scoliosis
Nerve foot compression

Question 21

What does bisphosphonates do?

Answer 21

Reduces vertebral fracture by 50%

Question 22

What is MRONJ?

Answer 22

Medication
Related
Osteonecrosis
Of the
Jaw

Question 23

If the patient has been on bisphosonates for >5 years what risk are they of MRONJ?

Answer 23

High risk

Question 24

If a patient has been taking bisphosphonates for <5 years what risk are they of MRONJ?

Answer 24

Low risk

Question 25

What is osteonceosis of the jaw?

Answer 25

Bone is exposed and begins to starve from lack of blood

Question 26

Symptoms of joint disease

Answer 26

Pain Immobility stiffness Loss of function

Question 27

Signs of joint disease

Answer 27

Swelling Deformity Redness Crepitus

Question 28

Investigations for joint disease

Answer 28

Radiography Blood tests Biopsy

Question 29

What is crystal arthropathies?

Answer 29

Gout

Question 30

What is gout?

Answer 30

Single joint acute arthritis

Question 31

What is hyperuricaemia?

Answer 31

High uric acid levels

Question 32

Where does gout most commonly affect?

Answer 32

The big toe

Question 33

What type of onset is gout?

Answer 33

Rapid

Question 34

What is used to treat gout?

Answer 34

NSAIDs Avoid aspirin

Question 35

What joints does oestoarthirits affect?

Answer 35

weight bearing joints

Question 36

Symptoms of oestoarthirits

Answer 36

Pain Morning stiffness

Question 37

Signs of oestoarthirits

Answer 37

loss of joint space lipping at joint edges swelling and deformity

Question 38

Treatment for oestoarthirits

Answer 38

Weight loss Increase muscle NSAIDs Prosthetic replacement for pain NOT function

Question 39

What does sero postive RA mean?

Answer 39

Rheumatoid factors are present

Question 40

What does sero negative RA mean?

Answer 40

Rheumatoid factors are not present

Question 41

Who is most commonly affected by rheumatoid arthritis?

Answer 41

Females age 20-50

Question 42

What type is onset is rheumatoid arthritis?

Answer 42

Slow starting in hands and feet

Question 43

Symptoms of rheumatoid arthritis

Answer 43

Fatigue Morning stiffness in joints Joint pain Minor joint swelling Numbness or tingling Decreased range of motion

Question 44

What are the early signs of rheumatoid arthritis?

Answer 44

Symmetrical synoyitis of MCP, PIP and wrist joints

Question 45

What are late signs of rheumatoid arthritis?

Answer 45

Dysfunction of the joint - cannot hyperextend Swan neck Ulner deviation

Question 46

What are some extra articulate features of rheumatoid arthritis?

Answer 46

changes to eyes or moth = sjorgrens syndrome

Question 47

How is rheumatoid arthritis investigated?

Answer 47

Radiographs Blood

Question 48

What is the treatment options for rheumatoid arthritis?

Answer 48

Physiotherapy Occupational therapy Drug Surgary

Question 49

What is the aim of drug use in rheumatoid arthritis?

Answer 49

Slow down the effects and pain

Question 50

What would happen during surgery for rheumatoid arthritis?

Answer 50

Replacement of the joint

Question 51

What drugs are given for rheumatoid arthritis?

Answer 51

Analgesics NSAIDs - Methotrexate Steroid injection for inflammation

Question 52

What drugs would be used in more severe cases of rheumatoid arthritis?

Answer 52

Biologics

Question 53

What type of disease is rheumatoid arthritis?

Answer 53

Immune disease

Question 54

Dental SE to drugs used for rheumatoid arthritis?

Answer 54

NSAIDs = bleeding Steroids = infection risk Hydroxychoroquine = oral lichenoid Methotrexate = ulcerstion

Question 55

What is ankylosing spondylitis?

Answer 55

Chronic condition that affects the spine and becomes inflamed

Question 56

Ankylosing spondylitis dental aspects

Answer 56

Limited mouth opening Limited neck flextion

Question 57

What is sjögren’s syndrome?

Answer 57

Condition that affects parts of the body that produces fluids

Question 58

What are symptoms of sjögren’s syndrome?

Answer 58

Dry eyes Dry mouth Dry skin

Question 59

What causes sjögren’s syndrome?

Answer 59

The immune system mistakenly attacks the body

Question 60

What is dry mouth?

Answer 60

There’s not enough salvia production

Question 61

Causes of dry mouth

Answer 61

Psychogenic Drugs Radiotherapy Dehydration

Question 62

Management of dry mouth?

Answer 62

Artificial saliva from - Orthana spray Glandosane spray BioXtra gel

Question 63

What is the pH of orthana?

Answer 63

Neutral

Question 64

What is the pH of BioXtra?

Answer 64

Neutral

Question 65

What is the pH of glandosane?

Answer 65

5.75

Question 66

What can dry mouth lead to?

Answer 66

Oral infections Perio disease Caries

Question 67

What advice would you give to someone with dry mouth?

Answer 67

Topical fluoride OHI Dietary advice Water