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Clinical Problem Solving > 5 - Joint Pain > Flashcards

5 - Joint Pain Flashcards

1
Q

List 2 biomarkers for rheumatoid arthritis.

A
  1. Rheumatoid factor

2. Anti-CCP (anti-cyclic citrillunated peptide

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2
Q

Why might a patient with septic arthritis present with fever?

A

Injury lead to infection

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3
Q

The main principle for managing osteoarthritis is halting ___.

A

Progression

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4
Q

What is the most common cause of septic arthritis?

A

Injury

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5
Q

What is the most common surgical treatment for osteoarthritis?

A

Joint replacement

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6
Q

List 2 reasons why rheumatoid factor is an unreliable biomarker for rheumatoid arthritis.

A
  1. Not found in all RA patients

2. Can be found in unaffected patients

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7
Q

When cartilage thins and cracks, what forms on the margins?

A

Osteophytes (bony spurs)

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8
Q

How can osteoarthritis cause genu varum?

A

Abnormal remodelling of joints

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9
Q

What type of joint would be found in the skull?

A

Fibrous

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10
Q

In addition to joints, rheumatoid arthritis can affect other parts of the body. List 4 organs that could be affected by rheumatoid arthritis.

A
  1. Lungs
  2. Eyes
  3. Pleura
  4. Pericardium
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11
Q

What is the most common cause of work absence in Western countries?

A

Back pain

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12
Q

Why does inflammation lead to an increase in blood flow?

A

Blood carries immune cells to the site of infection

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13
Q

What are menisci?

A

Discs of cartilage within certain synovial joints that enhance stability

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14
Q

List 2 serious underlying causes of back pain.

A
  1. Spinal stenosis

2. Bone metastases

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15
Q

What is septic arthritis?

A

Arthritis resulting from infection

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16
Q

Mechanical back pain does not radiate beyond the ___.

A

Knee

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17
Q

How does arthritis cause pain? (Hint: relates to inflammation.)

A

Inflammation -> tissue swelling -> stimulation of pain receptors

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18
Q

List 6 risk factors for osteoarthritis.

A
  1. Genetic
  2. Age
  3. Obesity
  4. Repetitive use
  5. Past injury
  6. Joint misalignment
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19
Q

The main principle for managing rheumatoid arthritis is the reduction of ___.

A

Inflammation

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20
Q

Compare the range of movement allowed by the 3 joint types.

A

Fibrous: None
Fibrocartilaginous: Some
Synovial: Extensive

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21
Q

What is the main function of synovial fluid?

A

Lubrication

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22
Q

What class of medication increases risk of gout?

A

Diuretics

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23
Q

What type of joint would be found in the limbs?

A

Synovial

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24
Q

Which type of arthritis is caused by the DEGENERATION of cartilage?

A

Osteoarthritis

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25
Q

Which connective tissue covers the surface of a synovial joint?

A

Cartilage

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26
Q

What type of liquid does the joint cavity contain?

A

Synovial fluid

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27
Q

What form of connective tissue holds joints together?

A

Ligaments

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28
Q

Joints are held together by ligaments. What is the main protein in a ligament?

A

Collagen

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29
Q

List the 3 types of joints.

A
  1. Fibrous
  2. Fibrocartilaginous
  3. Synovial
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30
Q

List 3 potential investigations for arthritis.

A
  1. Aspiration
  2. X-rays
  3. Blood test
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31
Q

What is subchondral sclerosis?

A

Abnormally thickened bone just below the cartilage

32
Q

Compare mono-arthritis and poly-arthritis.

A

Mono-arthritis: affects one join

Poly-arthritis: affects multiple joints

33
Q

What is the most effective pharmacological treatment for rheumatoid arthritis?

34
Q

List 3 signs of rheumatoid arthritis specific to the hands.

A
  1. MCP joint displacement
  2. Z deformity of the thumb
  3. Ulnar deviation
35
Q

What are pseudo-gout crystals made up of?

A

Pyruvic acid

36
Q

How does arthritis cause swelling? (Hint: relates to inflammation.)

A

Inflammation -> increased flow of fluids (i.e., blood and lymph) to the area

37
Q

How might kidney disease result in gout?

A

Less filtering of purines leads to uric acid buildup from purine breakdown

38
Q

What is spinal stenosis?

A

Narrowing of the spinal canal, resulting in pressure on the spinal cord

39
Q

Define articular.

A

Related to the joints

40
Q

What is the name for discs of cartilage within certain synovial joints that enhance stability?

41
Q

List 3 risk factors for rheumatoid arthritis.

A
  1. Genetic (60%)
  2. Female
  3. 40+
42
Q

Morning stiffness is a classic sign of ___ arthritis.

A

Rheumatoid

43
Q

List 3 treatments for mechanical back pain.

A
  1. Painkillers
  2. Rest
  3. Physiotherapy
44
Q

Which type of arthritis causes by autoimmune THICKENING of the synovial membrane?

A

Rheumatoid arthritis

45
Q

How does arthritis cause redness? (Hint: relates to inflammation.)

A

Inflammation -> increased blood flow to the area + leaky capillaries

46
Q

Compare acute and chronic onset.

A 
Acute = abrupt 
Chronic = long-term
47
Q

Both cartilage and bone are types of connective tissue made up of cells embedded in an ECM. List some differences in their traits.

A

Cartilage: thin, flexible, avascular
Bone: strong, rigid, vascular

48
Q

Herbenden’s nodes form on the ___ joints.

49
Q

List 5 structures found in a synovial joint.

A
  1. Bone
  2. Cartilage
  3. Synovial fluid
  4. Capsule
  5. Ligaments
50
Q

What is the name of the envelope surrounding a synovial joint?

51
Q

What are tophi?

A

Deposits of uric acid crystals

52
Q

Uric acid results from the breakdown of which substance?

53
Q

What is the mortality rate for septic arthritis?

54
Q

Compare passive and active range of movement.

A

Passive: YOU move the area
Active: PATIENT moves the area

55
Q

Compare the cause of osteoarthritis and rheumatoid arthritis.

A

Osteoarthritis: degenerative

Rheumatoid arthritis: auto-immune

56
Q

Which system of the body triggers inflammation?

A

Immune system

57
Q

List 3 treatments for osteoarthritis.

A
  1. Painkillers
  2. Anti-inflammatory drugs
  3. Lose weight
58
Q

Bouchard’s nodes form on the ___ joints.

59
Q

Which 2 types of joints are most commonly affected by osteoarthritis?

A
  1. High load joints (knees, hips)

2. Repetitive movement joints (fingers)

60
Q

How does osteoarthritis cause subchondral sclerosis?

A

Subchondral bone (directly beneath the cartilage) wears down, and the new bone grows back thicker than before

61
Q

List 2 types of nodes that can form on the fingers during osteoarthritis.

A
  1. Bouchard’s nodes

2. Herbenden’s nodes

62
Q

What are gout crystals made up of?

63
Q

In auto-immune conditions, why does the body attack normal tissue?

A

Sees it as foreign

64
Q

Which type of investigation would you use to examine synovial fluid?

A

Joint aspiration

65
Q

List 6 risk factors for gout.

A
  1. Genetic (60%)
  2. Obesity
  3. Diet – RED MEAT and SEFOOD
  4. Alcohol
  5. Kidney disease
  6. Diuretics
66
Q

What underlying pathology would reduced active range of movement indicate? (Hint: reluctance to cause self pain.)

A

Damage to joint or surrounding structures

67
Q

How does arthritis cause warmth? (Hint: relates to inflammation.)

A

Inflammation -> increased blood flow to the area

68
Q

What is the effect of a thickened synovial membrane on volume of synovial fluid produced?

A

Increased production of synovial fluid

69
Q

What is the most reliable biomarker for rheumatoid arthritis?

A

Anti-CCP (anti-cyclic citrillunated peptide)

70
Q

List 5 red flags for back pain with a serious underlying cause.

A
  1. Age (<20 or >55)
  2. No relief with rest
  3. Radiates to chest
  4. PMH (cancer, osteoporosis, HIV, etc.)
  5. Associated symptoms (sweats, weight loss, fever, etc.)
71
Q

What is the capsule (re: joints)?

A

Envelope surrounding synovial joints

72
Q

What type of joint would be found between vertebrae?

A

Fibrocartilaginous

73
Q

What is joint stiffness?

A

Restricted range of movement

74
Q

What is the most common age group for mechanical back pain?

75
Q

What is the most rapid and destructive bone disease?

A

Septic arthritis

76
Q

Why might you order a blood test for arthritis?

A

To check for biomarkers

77
Q

What would reduced passive range of movement indicate?

A

Joint damage

Clinical Problem Solving (10 decks)

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