WEEK 6-Musculoskeletal

Question 1

What is osteoporosis

Answer 1

A metabolic bone disease where bone resorption exceeds formation, leading to decreased bone density, porous bones and increased fracture risk

Question 2

What causes osteoporosis at the cellular level

Answer 2

Imbalance between osteoclast (bone-resorbing) and osteblast (bone-building) activity, driven by hormones, cytokines and vitamin deficiencies

Question 3

What are modifiable risk factors osteoporosis

Answer 3

smoking, alcohol use, low calcium/vitamin D intake, sedentary lifesttle, high caffeine or sodium and long-term corticosteroid use

Question 4

What are non-midifiable risk factors for osteoporosis

Answer 4

Age>65, female sex, family history, endocrine disorders and post-menopausal status

Question 5

What is DEXA scan and what does it measure?

Answer 5

A diagnostic test that measures bone mineral density (BMD), reported as a T-score to diagnose osteoporosis and fracture risk

Question 6

What are complications of advanced osteoporosis

Answer 6

Pathological fractures (hip, vertebrae, wrist), kyphosis, height loss and chronic pain

Question 7

What is degenerative disk disease (DDD)

Answer 7

age-related deterioration or herniation of spinal discs leading to pain, reduced mobility and nerve root compression

Question 8

What are clinical manifestations of lumbar DDD

Answer 8

lower back pain, radiculopathy, reduced flexibility and muscle weakness

Question 9

what conservative treatments are used for DDD

Answer 9

Physiotherapy, spinal bracing, core strengthening, NSAIDs, anglesics and antidepressants

Question 10

When is surgery indicated for DDD

Answer 10

For severe pain or neurological deficits to conservative treatment

Question 10

What is osteoarthritis (OA)

Answer 10

a degenerative joint disease caused by cartilage breakdown, leading to pain, stiffness and reduced mobilty

Question 11

How does OA progress pathophysiologically

Answer 11

Cartilage becomes thin and brittle, osteophytes form, joint space narrows, and synovial inflammation can develop.

Question 12

What are symptoms of OA?

Answer 12

Joint stiffness (especially in the morning), pain, crepitus, swelling, and asymmetry.

Question 13

What joints are most commonly affected in OA?

Answer 13

Knees, hips, spine, and hands.

Question 14

What is rheumatoid arthritis (RA)?

Answer 14

A chronic autoimmune disease causing systemic inflammation and symmetrical joint destruction.

Question 15

What are early systemic signs of RA?

Answer 15

What are early systemic signs of RA?

Question 16

What are early systemic signs of RA?

Answer 16

Small joints (hands, feet), and eventually larger joints (knees, elbows).

Question 17

What is pannus in RA?

Answer 17

Inflammatory granulation tissue that invades and destroys cartilage and bone within joints.

Question 18

What are common deformities in RA?

Answer 18

Swan neck, boutonnière, and ulnar deviation of the fingers.

Question 19

Swan neck, boutonnière, and ulnar deviation of the fingers.

Answer 19

Disease-modifying anti-rheumatic drugs that slow progression of RA and PsA (e.g., methotrexate).

Question 20

What is psoriatic arthritis (PsA)?

Answer 20

An inflammatory arthritis associated with psoriasis, involving skin, nails, and joints.

Question 21

What are symptoms of PsA?

Answer 21

Joint pain, swelling, dactylitis (sausage digits), enthesitis, and nail changes like pitting.

Question 22

What is gout?

Answer 22

A type of arthritis caused by excess uric acid leading to crystal deposits in joints.

Question 23

What joint is commonly affected in gout?

Answer 23

The first metatarsophalangeal joint (big toe).

Question 24

What are triggers of gout flares?

Answer 24

Alcohol, red meat, seafood, dehydration, trauma, and some medications (e.g., diuretics).

Question 25

What are signs of acute gout?

Answer 25

Sudden joint pain, swelling, redness, warmth, and systemic inflammation (e.g., fever).

Question 26

What is tophi?

Answer 26

Visible deposits of urate crystals in soft tissues from chronic gout.

Question 27

What is septic arthritis?

Answer 27

A joint infection, usually bacterial, causing rapid inflammation, pain, and joint destruction.

Question 28

What are signs of septic arthritis?

Answer 28

Single hot, swollen joint, severe pain, fever, decreased ROM, and systemic symptoms.

Question 29

What is the most common pathogen in septic arthritis?

Answer 29

Staphylococcus aureus.

Question 30

How is septic arthritis treated?

Answer 30

Urgent IV antibiotics and possible surgical drainage

Question 31

What pharmacological classes are used in musculoskeletal disorders?

Answer 31

NSAIDs, corticosteroids, analgesics, DMARDs, bisphosphonates, and anti-gout agents.

Question 32

What do bisphosphonates do?

Answer 32

Inhibit bone resorption by osteoclasts, used in osteoporosis treatment.

Question 33

Name a biological DMARD.

Answer 33

Etanercept — targets TNF-alpha to reduce inflammation in autoimmune arthritis.

Question 34

What is a major nursing consideration when giving corticosteroids?

Answer 34

Monitor blood glucose, bone density, infection risk, and wean off gradually to prevent adrenal suppression.

Question 35

What are nursing interventions for arthritis?

Answer 35

Pain management, promoting mobility, heat/cold therapy, education on medication adherence, and joint protection.

Question 36

What are signs of musculoskeletal deterioration?

Answer 36

Sudden pain, immobility, neurological deficit, fever (septic arthritis), or worsening deformity.

Question 37

What assessments are involved in a focused musculoskeletal exam?

Answer 37

Inspection, palpation, ROM, strength, gait, posture, swelling, and functional limitation.

Question 38

What is the nursing management after a fracture?

Answer 38

Neurovascular observations, pain relief, immobilisation, elevation, wound care, and pressure area prevention.

Question 39

What is the goal of nursing care in osteoporosis?

Answer 39

Prevent falls and fractures, promote bone health, manage pain, and support safe mobility.

Question 40

What are signs of a fat embolism post-fracture?

Answer 40

Respiratory distress, altered mental status, petechial rash.

Question 41

What is ankylosis?

Answer 41

Abnormal fusion of bones within a joint, often seen in advanced arthritis.

Question 42

How is gout diagnosed?

Answer 42

Joint aspiration showing monosodium urate crystals, high serum uric acid, and clinical presentation.

Question 43

What is enthesitis in PsA?

Answer 43

Inflammation at the site where tendons/ligaments insert into bone.

Question 44

What is subluxation in RA?

Answer 44

Partial dislocation of a joint due to ligament and cartilage damage.

Question 45

What team members are involved in MSK management?

Answer 45

Nurse, GP, rheumatologist, physiotherapist, pharmacist, orthopaedic surgeon, and occupational therapist.

Question 46

What is fibrous ankylosis?

Answer 46

Joint stiffness due to fibrous tissue proliferation and loss of cartilage — a late-stage complication of arthritis.

Question 47

Why is patient education vital in MSK care?

Answer 47

It supports medication adherence, lifestyle modification, injury prevention, and early recognition of flares.

Question 48

What is kyphosis and what causes it in osteoporosis?

Answer 48

An excessive outward curve of the spine caused by vertebral compression fractures.

Question 49

What are common complications of untreated RA?

Answer 49

Joint deformity, disability, systemic inflammation, lung disease, and premature cardiovascular disease.