57 Musculoskeletal 1

Question 1

What is an arthritidies?

Answer 1

Any inflammation causing pain and stiffness in the joints.

Question 2

Which underlying diseases are often found in osteoarthritis? (2).

Answer 2

Obesity.

Diabetes.

Question 3

Differentiate between the common sites of osteoarthritis in women and men.

Answer 3

Women: kees and hands.
Men: hips.

Question 4

Describe the pathogenesis of osteoarthritis: (3).

Answer 4

Cartilage erosion.
Bony spur formation.
Subchondral cyst formation.

Question 5

What is the molecular pathogenesis of OA? (2).

Answer 5

Chondrocytes release IL-1 initiating matrix breakdown.

Prostaglandin derivatives induce lytic enzyme release - preventing formation.

Question 6

What involvement in fingers is found in OA? (2).

Answer 6

Herberden’s nodes.

Bouchard’s nodes.

Question 7

Describe the Robbins Pathologic basis of RA: (3).

Answer 7

Synoviocyte hyperplasia produces pannus which erodes cartilage.
Continued erosion penetrates subchondral bone and forms cysts.
Ankylosis: pannus fills joint space.

Question 8

What are the first symptoms of RA? (3).

Answer 8

Malaise.
Fatigue.
Generalised MSK pain.

Question 9

Which genes confer genetic susceptibility to RA? (2).

Answer 9

HLA DR4/DR1.

Question 10

What are the exogenous arthritogens involved in RA? (3).

Answer 10

EBV.
Virus’.
Borrelia.

Question 11

What are the mediators of joint damage in RA? (5)

Answer 11

CD4 T cells.
IL 1, IL 6.
TNF α + β.

Question 12

Name four serognegative arthritides:

Answer 12

Ankylosing spondylitis.
Reiter’s syndrome.
Psoriatic arthritis.
Enteropathic arthritis.

Question 13

What are the clinical features of gout? (4).

Answer 13

Acute + transient arthritis.
Chronic arthritis.
Tophi (uric acid deposition in joints).
Gouty nephropathy.

Question 14

What are the three signs of infective arthritis?

Answer 14

Fever.
Leucocytosis.
Elevated ESR.

Question 15

What are the causes of secondary osteoporosis? (4).

Answer 15

Hyperparathyroidism.
Type 1 diabetes.
Multiple myeloma.
Malnutrition.

Question 16

Which infection leeds to paget’s disease of the bone?

Answer 16

Paramyxovirus.

Question 17

Where does Paget’s disease of the bone occur most commonly?

Answer 17

Axial and proximal skeleton.

Question 18

What is Osteitis fibrosa cystica?

Answer 18

Loss of bone mineral with osteoporosis.

Question 19

Which changes are seen in renal osteodystrophy? (5).

Answer 19

Increased osteoclastic bone resorption.
Delayed matrix mineralization.
Osteosclerosis.
Growth retardation.
Osteoporosis.