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CMS Revision > Musculoskeletal Disease > Flashcards

Musculoskeletal Disease Flashcards

1
Q

What parts of the body does osteoarthritis affect?

A

Hands and weight bearing joints

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2
Q

What is osteoarthritis associated with?

A

Obesity
Genetics
Previously damaged joint or bone

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3
Q

Does oteoarthritis affect part of a joint or the whole joint?

A

Whole joint

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4
Q

Is osteoarthritis more common in men or women?

A

Women

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5
Q

What are the symptoms of osteoarthritis?

A

Pain that is worse on movement
Immobility
Swelling
Deformity

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6
Q

How is osteoarthritis diagnosed?

A

Clinical exam
Radiology if disease is advanced
MRI scan

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7
Q

How is osteoarthritis managed?

A 
Lose weight
Physio
Analgesics
No symptoms = no treatment
Steroid injections
Joint replacement
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8
Q

What is rheumatoid arthritis?

A

An auto immune disease of unknown aetiology

Joint destruction due to synovial inflammation

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9
Q

Compared to osteoarthritis, rheumatoid arthritis is…?

A

More localised

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10
Q

How common is rheumatoid arthritis and who does it affect more?

A

1-3% of population

3x more women

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11
Q

What is the peak onset for rheumatoid arthritis?

A

30-50

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12
Q

What are the signs and symptoms of rheumatoid arthritis?

A 
Joint pain initially with hands and feet
Later cervical spine, knees, ankles, elbows and shoulders
Acute = Hot, swollen and tender
Established = Deformity, and restriction 
Heart disease
Lung problems 
Kidney failure
Sjogrens syndrome
Systemic inflammation
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13
Q

What do 1/4 of cases of rheumatoid arthritis show?

A

Symmetrical onset

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14
Q

What effects can rheumatoid arthritis have on the nervous system?

A

Peripheral neuropathy

Cervical cord compression - paralysis

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15
Q

How is rheumatoid arthritis diagnosed?

A

Clinical exam
Blood tests - full blood count
Anti CCP test

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16
Q

How is the disease severity established with rheumatoid arthritis?

A

Radiographically

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17
Q

What makes the prognosis of rheumatoid arthritis worse?

A

If pt is a woman

If they are diagnosed as anaemic within 3 months of diagnosis of rheumatoid arthritis

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18
Q

How is rheumatoid arthritis managed?

A 
Analgesia 
Disease modifying anti rheumatic drugs
Corticosteroids 
Surgery - joint replacement
Physic
Occupational therapy
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19
Q

Why patients with rheumatoid tend to have better dexterity than patients with osteo?

A

Rheumatoid progresses slowly over time so give pts a change to get used to it

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20
Q

What is systemic sclerosis?

A

An auto immune disease that affects mainly the skin - thickened skin that is bound to underlying structures

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21
Q

Does systemic sclerosis occur more in men or women?

A

3-5x more in women

22
Q

What age does systemic sclerosis present?

A

Middle age

23
Q

What are the signs and symptoms of systemic sclerosis?

A

Sclerodactyly
Telangiectasis
Characterised appearance - beaked nose, fixed expression, radial furrowing of lips and limitation in mouth movement

24
Q

How is systemic sclerosis diagnosed?

A

Clinical exams

Blood tests

25
Q

What is systemic lupus erythematous?

A

A multi system auto immune disease

26
Q

What % of the population does systemic lupus erythematous affect and is it more common in men or women?

A

0.1%

9x more common in women

27
Q

What is the average age onset for systemic lupus erythematous?

A

20-40 years

28
Q

What are the symptoms of systemic lupus erythematous?

A 
Photosensitivity of skin
Butterfly rash on face
Small joint arthritis 
Raynaulds disease
Heart problems
Lung problems
Kidney failure
Nervous system problems
29
Q

How is systemic lupus erythematous diagnosed?

A

Clinical exam

Test for specific ago antibodies

30
Q

How is systemic lupus erythematous managed?

A 
Analgesia 
Disease modifying anti rheumatic drugs
Corticosteroids 
Surgery - joint replacement
Physic
Occupational therapy
Psychological practical support
31
Q

What is gout?

A

Accumulation of rate crystals in joints

32
Q

Who is gout most common in?

A

Older men

33
Q

What is psonatic arthritis associated with?

A

Psoriasis

34
Q

What is hyperparathyroidism?

A

Excess of parathyroid hormone

35
Q

What are the symptoms of hyperparathyroidism?

A 
Hypercalcaemia 
- malaise
- depression
- constipation
- abdominal pains
- kidney stones 
Bone pain
36
Q

How is hyperparathyroidism diagnosed and managed?

A

Diagnosed - blood tests and X-rays

Management - Parathyroidectomy or drugs

37
Q

What does hyperparathyroidism affect dentally?

A

Bone resorption

Loss of lamina dura around roots

38
Q

What is pagets disease?

A

Abnormal bone remodelling and abundant new bone formation

39
Q

What are patients with pagets disease prone to?

A

Fractures

40
Q

In pagets disease, what is the bone resorption initially replaced with?

A

Fibro-vascular tissue

41
Q

What eventually happens to the bone remodelling and bone resorption?

A

They level off

42
Q

What are the signs and symptoms of pagets?

A 
Most completely asymptomatic 
Bone deformities 
- enlargement of skull
- nerve compression 
- fractures
43
Q

How is pagets diagnosed?

A

Clinical exam
Xrays
Hypercementosis of roots of teeth

44
Q

How is pagets managed?

A

With bisphosphonates

45
Q

What is osteomalacia?

A

Vitamin D deficiency

46
Q

What are the symptoms of osteomalacia?

A

Diffuse bone pain

Proximal muscle

47
Q

How is osteomalacia diagnosed?

A

Xrays and blood tests

48
Q

What does osteomalacia affect in children?

A

Development of teeth

49
Q

What is osteoporosis?

A

Loss of bone mass

50
Q

What are patients who suffer osteoporosis prone to?

A

Fractures

51
Q

What are the risk factors for developing osteoporosis?

A 
Female
Alcohol
Thin
White
Lack of exercise
Short menstrual cycle history 
Malabsorption 
Hyperthyroidism
Hyopgonadism
52
Q

How is osteoporosis managed?

A

Diagnosis with a DEXA scan
Pharmacological
Calcium and vitamin D

CMS Revision (12 decks)

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