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Medicine: PBL wrap-ups > Unit 5 Case 2: Osteoarthritis > Flashcards

Unit 5 Case 2: Osteoarthritis Flashcards

(69 cards)

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1
Q

definition of osteoarthritis

A

clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life

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2
Q

2 types of osteoarthritis

A

primary
secondary

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3
Q

primary osteoarthritis

A

more generalised
affects various parts of the body

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4
Q

secondary osteoarthritis

A

occurs after injury
typically injury that causes joint inflammation

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5
Q

histological changes seen in osteoarthritis

A

chondrocytes proliferate, cluster and form MMP’s
extracellular matrix will lose aggrecan, type 2 collagen degradation and cartilage cracks
cartilage will decrease swelling pressure of proteoglycans, altered collagen synthesis, loss of shock absorption

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6
Q

changes seen in osteoarthritis

A
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7
Q

different types of arthritis

A

rheumatoid
psoriatic
gout

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8
Q

rheumatoid arthritis

A

autoimmune disease
immune system attacks the joints
leads to inflammation
results in severe joint damage if left untreated

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9
Q

psoriatic arthritis

A

autoimmune inflammatory disease
causes raised, red and white patches of inflamed skin with scales normally on the elbows, knees, scalp and navel
can also swell the fingers and the toes

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10
Q

gout

A

form of inflammatory arthritis
more centralised
occurs when uric acid crystals build up in joints, results in painful inflammation
most often affects the big toe

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11
Q

healthy synovium

A

1-2 cells thick
macrophage like synovial cell, synoviocytes type 1
fibroblast like synovial cells type 2
synovial subliming is loose connective tissue with numerous blood and lymphatic vessels, nerves, scattered macrophages and fibroblasts

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12
Q

what is in the image

A
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13
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what is in the image

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14
Q

what is in the image

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15
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what is in the image

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16
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what is in the image

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17
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what is in the image

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18
Q

what is in the image

A
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19
Q

symptoms of osteoarthritis

A

pain
morning stiffness
tenderness
losss of flexibility
bone spurs
grating sensation
swelling

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20
Q

clinical presentation of osteoarthritis

A

hip tenderness
range of passive and active motion
crepitus with movement
pain when pressure is placed on the hip
gait problems
sign of injury to muscles, tendons and ligaments surrounding the hip

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21
Q

identify features of osteoarthritis on knee joint

A
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22
Q

identify features of osteoarthritis on hip joint

A
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23
Q

what is in the image

A
  1. heberden nodes
  2. Bouchard nodes
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24
Q

what is in the image

A

1st carpometacarpal joint squaring

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25
describe the gait cycle
1. initial contact of heel with floor 2. weight transferred to this leg 3. weight is aligned and balanced on this leg 4. heel lifts off floor as foot rises, toes in contact with floor 5. foot continues to rise, toes lift off floor 6. foot swings forwards and comes back into contact with floor with a heel strike
26
examples of some different gaits
antalgic hemiplegic diplegia ataxic myopathic neuropathic parkinsonian choreiform
27
antalgic gait
abnormal that develops as a result of pain, stance phase reduced on affected limb means limp
28
choreiform gait
presents with involuntary movements
29
myopathic gait
weakness of hip adductors resulting in a waddling appearance
30
neuropathic gait
caused by weakness of muscles in distal limb due to damage to peripheral providing motor innervation
31
parkinonian gait
caused by rigidity and bradykinesia because of loss of dopaminergic neurone in basal ganglia nerves
32
ataxic gait
broad-based, midline, cerebellar disease, vestibular disease loss of proprioception
33
diplegic gait
may Be caused by CNS lesion
34
hemiplegic gait
caused by CNS lesion unilateral weakness and spasticity
35
clinical presentation of knee joint osteoarthritis
anatalgic gait trendelenburg/myopathic/waddling gait varus and valgus
36
describe the image
varus: bow legged, knees curve outwards, leaving a wide space valgus: knock knees, knees touch and feet are significantly apart when standing
37
hallux valgus
clinical presentation of osteoarthritis in the feet looks like gout bunions of feet
38
clinical presentation of hip joint osteoarthritis
trendelenburg test c- sign
39
trendelenburg test
stand on one leg and see if the opposite hip drops positive sign= contralateral pelvic drop during single leg stance, could be superior nerve damage
40
C-sign
pain anteriorly and laterally of hip causes patient to grab the painful area, creates a c shape with their hand
41
normal range of hip movement flexion
0-125
42
normal range of hip movement extension
115-0
43
normal range of hip movement external rotation
0-45
44
normal range of hip movement internal rotation
0-45
45
normal range of hip movement abduction
0-45
46
normal range of hip movement adduction
45-0
47
subchondral sclerosis
hardening of bone just below the cartilage surface later stages of osteoarthritis abnormally white bone along the joint line common in knees and hips area just below cartilage layer fills with collagen and becomes denser than healthy bone
48
avascular necrosis of hip
damage of the blood supply that enters femoral head through neck of the femur bone can lead to the death of the femoral head causes the femoral head to collapse and begin to flatten flattening then causes the femoral head to not fit perfectly inside of the socket joint then wears out
49
what causes avascular necrosis of the hip
injuries fractures hip dislocation medication, cortisone excessive alcohol intake deep-sea divers/ miners under high atmospheric pressure causes tiny bubbles to form in the blood stream
50
subchondral cyst
fluid-filled space inside a joint that extends from one of the bones that forms the joint caused by osteoarthritis may require aspiration
51
what are the different risk factors for osteoarthritis
sex older age joint injuries obesity repeated stress on the joint genetics bone deformities metabolic disorders
52
sex as a risk factor for osteoarthritis
women are more likely
53
joint injuries as a risk factor for osteoarthritis
even if this occurred years ago could be from sports/accidnets etc
54
obesity as a risk factor for osteoarthritis
extra body weight extra joint stress fat tissue produces proteins causing inflammation in/around joints
55
bone deformities as a risk factor for osteoarthritis
some born with malformed joints/defective cartilage
56
metabolic disorders as a risk factor for osteoarthritis
diabetes hemochormatosis (body has too much iron)
57
constitutional risk factors for osteoarthritis
ageing hereditary gender hormonal status (menopause) metabolic bone disease (Pagets)
58
local risk factors for osteoarthritis in the knee
obesity quadriceps weakness joint laxity/malalignment
59
local risk factors for osteoarthritis in the hip
developmental dysplasia occupation
60
pharmacological management of osteoarthritis
61
non-pharmacological management of osteoarthritis
62
surgical management of osteoarthritis
63
NICE guidelines for osteoarthritis treatment
exercise and physiotherapy is the first line of treatment patient education= self management support weight management medication management surgery is last resort referral to specialist services
64
NICE guidelines for information giving
chunk and check discussions patient decision aids 3 talk model: choice, options, preferences given then to make an informed decision
65
drugs used in the treatment and management of osteoarthritis
paracetamol aspirin curcumin rosehip extract naproxen glucosamine chondroitin omeprazole MOA in separate flashcards
66
definition of coping
process of using behavioural and cognitive approaches to manage difficult or threatening situations and plays on an integral role in maintaining physical and mental well-being of an individual
67
what can coping be
emotion focused or problem solving strategies adaptive or maladaptive strategies
68
internal coping factors
biological or psychological behaviour
69
external coping factors
social influences

Medicine: PBL wrap-ups (21 decks)

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