Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Master Semester 1 > ACT 1 - Rheumathology > Flashcards

ACT 1 - Rheumathology Flashcards

1
Q

Osteoporosis - definition

A

Bone weakening die to porous in bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Osteoporosis - demografics

A

1 in 2 female above 50%

In male 1 in 5 - common as a secondary cause to another condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Osteoporosis - Pathogenesis

A

Bone remodels through life
Peak bone density at 30, and then lose 1% a year. Women after menopause lose 2.5% a year.
Regulated by hormones
Osteoblast build bone (PTH, Vit. D, TH, interleukin)
Osteoclast reabsorbed bone (Estrogen, Progesterone, Calcitronin, Androgens)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Osteoporosis - Environmental Risk factors

A 
smoking 
alcohol 
Calcium deficient diet 
lack of weight-bearing exercise
Hormone deficiency
Lack of Vit. D
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Osteoporosis - Medical Risk Factors

A
  • Eating disorder
  • Malabsorption syndrome (Celiac)
  • Chronic organ failure
  • Prolonged immobilization
  • Endocrine Disorder (cushions, Diabetes Mellitus, thyrotoxicosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Osteoporosis - Screening methods

A

DEXA - dual energy Xray - medicare rebate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Osteoporosis - medications

A

Biophosphonates - inhibit bone reabsortion
Selective Estrogen modulators - slow bone loss
Hormone replacement therapy - normalises oestrogen levels which slow down bone loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Osteoporosis - Osteo treatment

A

Supervised resistance training Balance exercises
OT assessment at home
Gp medication review for dizziness Optomotrist for eye testing.

Increase: calcium, vitamin D levels

Decrease: smoking and alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Osteomyelitis - definition

A

Bone infection - progressive inflammatory destruction of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Osteomyelitis - Demographics

A

Children

affects long bone and spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Osteomyelitis - Cause

A

Staphylococus aureus – approx 80%
Gram – negative bacteria
Fungal infections in chronically ill Salmonella in Sickle Cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Osteomyelitis - common infection sites

A

Long bones
Vertebra - Lx> Tx > Cx Radius
SIJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Osteomyelitis - Pathophys - 5 phases

A

Blood borne bacterial spread

  1. Acute inflammatory inflammation
  2. Pus formation at bone periosteum
  3. Necrosis - sequestrum (segment of dead bone)
  4. Formation new bone (involcrum) to surround infection
  5. Resolution - anti biotic therapy and pressure release (surgery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Osteomyelitis - classification

A
  • spread from contiguous source - trauma/ post-surgery

- secondary osteomyelitis in patients with vascular insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Osteomyelitis - Clinical presentation kids

A
  • Often present with symptoms prior radiograph evidence
  • Often muted or covert symptoms
    Malaise, pain, fatigue,
  • Often with history of trauma
  • Pseudoparalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Osteomyelitis - Clinical presentation adults

A
  • Usually immuno-compromised or elderly
  • Bone tenderness
  • Limp or decreased limb function
  • Muscle spasm or other soft tissue involvement (this is often the initial symptom!)
  • Pyrexia and malaise (if infection spread)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Osteomyelitis - diagnosis

A 
difficult to diagnose 
MRI - children
Biopsy 
raised ESP
Radionucleide x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Osteomyelitis - treatment

A
  • immediate referral from osteo
  • antibiotic
  • drainage
  • surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Osteoarthritis - demographic

A

40+
70+
obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Osteoarthritis -pathophys

A

Primary: disease of articular cartillage

Secondary: decrease friction of joints
resist tension
resist heavy compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Osteoarthritis - Clinical presentation

A

Usually gradual and slow onset
Weightbearing joints

Pain

  • Stiffness first thing in the morning that eases Pain worst at the end of the day
  • Relieved by rest
  • Worse with colder weather

Signs

  • Bony enlargement Crepitus
  • Restricted movement Tenderness on palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Osteoarthritis - Diagnosis

A

X-ray if changes treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Osteoarthritis - Radiological findings

A

Loss of joint space
Osteophytic growth Subchondral bone cyst Subchondral sclerosis
Asymmetrical distribution Intra-articular loose bodies Articular deformity
Vacuum phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Osteoarthritis - Management

A

Provide education and reassurance

Medication
- Slow-release paracetamol is the most common

Correct risk factors that are modifiable
Weight loss Injury Overuse
Exercise
Manual therapy to address biomechanical compensations Joint replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Rheumatoid Arthritis (RA) - Definition

A

Autoimmune disease that causes pain, swelling, and stiffness in the joints, and may cause severe joint damage, loss of function, and disability. The disease may last from months to a lifetime, and symptoms may improve and worsen over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Rheumatoid Arthritis (RA)- epidemiology

A

W 3>1
40+
Affects 1-2% pop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Rheumatoid Arthritis (RA) - Clinical features

A 
- Early stage
Insidious onset 
Joint pain and stiffness MCP and PIP
sleep disturbance
painful walking
Morning stiffness last hours
swelling
tenderness on joint palpation
  • Late stage
    Joint deformity, subluxation, instability
    Systemic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Rheumatoid Arthritis (RA) - types of joint deformities

A
  • boutonnière
  • swan neck
  • Z deformity
  • Ulnar deviation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Rheumatoid Arthritis (RA) - Other clinical features

A
  • Blood: anemia
  • SKin: Rheumatoid nodules, vasculitis
  • Eye: scleritis, sjogrens syndrome
  • Lung: pleural effusion, nodules
  • Cardiac: pericarditis, myocarditis, atherosclerosis
  • renal: amyloidosis
  • Neurological: pheripheral neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Rheumatoid Arthritis (RA) - Diagnosis

A
  • persistent joint pain and swelling
  • bilat joint RA
  • morning stiffness > 30min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Rheumatoid Arthritis (RA) - investigations

A
  • ESR/ CRP
  • Anti CCP
  • Xray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Rheumatoid Arthritis (RA) - MAnagement

A
  • analgesic, NSAID
  • Education
  • Anti rheumatic drugs
  • REST on flare up
  • Exercise
  • Diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ankylosis Spondylitis - Definition

A

Fusion of Tx and SIJ

34
Q

Ankylosis Spondylitis - Epidemology

A
  • Start < 30
  • M 2>1
  • HLA-B27 positive
  • Genetic
35
Q

Ankylosis Spondylitis - pathogenesis

A

Immune response to HLA-B27 leads to inflammation and tissue destruction

36
Q

Ankylosis Spondylitis - clinical features

A
  • LBP, SIJP
  • restricted Lx AROM
  • Ankylosis SIJ
  • movement restriction + deformity
37
Q

Ankylosis Spondylitis - other clinical features

A
  • Enthesitis (tendon attachment point inflammation) ankle
  • Ant. Uveitis (eye inflammation)
  • peripheral arthritis
  • Bowel inflammation

Late stage:

  • Osteoporosis
  • pulmonary fibrosis
  • Aortic valve incompetence
38
Q

Ankylosis Spondylitis - diagnosis

A
  • Xray SIJ
  • MRI
  • ESR/ CRP (inflammation in body)
39
Q

Ankylosis Spondylitis - Management

A
  • Education
  • Keep active
  • NSAID
  • TNF inhibitors
    Dmards (Anti rheumatic drug)
40
Q

Psoriatic arthritis - Definition

A

Autoimmune disease characterised by red scaly patches

41
Q

Psoriatic arthritis - Epidemology

A

M=W

30-50yr

42
Q

Psoriatic arthritis - classification

A
  • Distal predominant: DIP + PIP
  • Oglioarticular: Joints <5
  • Polyarticular > 5
  • Spondylitis: SIJ + Cx
  • Arthritis Mutilans: Distal predominant - bone erosion
43
Q

Psoriatic arthritis - Clinical features

A

Pheripheral Arthritis:

  • gradual onset
  • multiple joints
  • symetrical

Axial Arthritis

  • mimic AS
  • progress to ankylosis
44
Q

Psoriatic arthritis - Other clinical features

A

Dactylitis (swelling entire digit)
Enthesitis (AS)
Tendonitis/Tenosynovitis

45
Q

Psoriatic arthritis - Diagnosis

A
  • Diagnosed by clinical features
  • test rheumatoid factor and Anti-CPP
  • Xray
46
Q

Psoriatic arthritis - Management

A
  • control of skin lesions
  • refer to dermatologist
    UV therapy
    DMARDS
    Biologic Medications
47
Q

Septic Arthritis - Definition

A

Infectious Arthritis due to bacteria

  • staph A
  • Gonorrhoea
48
Q

Septic Arthritis - Epidemiology

A 
60+ and kids
Immunocompromised
Joint replacement
Joint trauma
Osteomyelitis
RA
49
Q

Septic Arthritis - Clinical Features

A

Swelling in joint (red + hot)
Restricted Joint range
systemic symptoms

50
Q

Septic Arthritis - Diagnosis

A

Synovial fluid aspirate
ESR/CRP
Xray/ MRI

51
Q

Septic Arthritis -Management

A

Medical interventions immediately
fluid aspiration + surgical drainage
Antibiotic

52
Q

Systemic Lupus - Definition

A

SLE = Lupus

Autoimmune disease by multi systemic clinical manifestations

53
Q

Systemic Lupus - Epidemiology

A

Women 15-35
Asia-indigenous
Joint skin and mucosa symptoms

54
Q

Systemic Lupus - Epidemiology

A

Women 15-35
Asia-indigenous
Joint skin and mucosa symptoms
genetic

Environmental

  • UV
  • Epsein barr virus
  • Drug induced

Hormonal: Oestrogen

55
Q

Systemic Lupus - Pathogenesis

A

recurrent activation of immune system. Antibodies and protein lead to inflammation and tissue destruction

56
Q

Systemic Lupus - Clinical features

A
  • Butterfly rash

- Arthritis: periphery of 2+ joints, symmetrical, bilat.

57
Q

Systemic Lupus - Other clinical features

A
  • lupus nephritis (renal)
  • Blood: anemia, leukopenia, thrombocytopenia (low white and red blood cels)
  • serositis (inflammation of lung lining
  • Systemic conditions
58
Q

Systemic Lupus - Diagnosis

A 
- Blood test: 
Antinuclear antibody ANA
ENA antibody
ESR/CPR
Rheumatoid factor
59
Q

Systemic Lupus - Management

A

NSAID
Antimalarials (antiparasite)
corticosteroid
immunosuppressive drugs

60
Q

Reactive Arthritis - Definition

A

Secondary to bacterial infection at GI or GU tract

Reiters Syndrome

61
Q

Reactive Arthritis - Epidemology

A 
Rare
GI infection M=W
STI M>W
White 
Low socioeconomic
62
Q

Reactive Arthritis - Pathogenesis

A

GI or UTI infection
chlamydia, salmonela
E.coli
Immune response to bacteria leads to T cell activation and molecular arthritis

63
Q

Reactive Arthritis - Clinical features

A
  • Asymetrical Oligoarthritis on knee and ankle
  • Uveitis/ conjuctivitis
  • Penile lesion
  • skin lesion
64
Q

Reactive Arthritis - Diagnosis

A

Rule out other conditions
Rule out ESR CPR
Test for infection

65
Q

Reactive Arthritis - Management

A

Antibiotics
NSAID
DMARD
general mobility

66
Q

Gout - Definition

A

Monosodium urate crystal disorder.

urate crystal deposition on joints

67
Q

Gout - Epidemology

A
  • Men 40-50 > Women 60+
  • Indigenous
  • genetic 35%
  • Renal disease
  • prolonged use of diuretics
  • Beer and soft drinks
68
Q

Gout - Pathogenesis

A

Uric acid is unable to be filtered out by kidneys (hyperuricemia) occurs creating saturation of uric in synovial fluid and tissue later forming crystals

69
Q

Gout - Stages

A
  • Stage 1: Asymptomatic Hyperuricemia
  • Stage 2: Acute gout arthritis
  • Stage 3: Intercritical gout (intervals between attacks)
  • Stage 4: Chronic gout and gouty arthritis
70
Q

Gout - Clinical features asymptomatic Hyperuricemia

A

Elevated serum acid

71
Q

Gout - Clinical features Gouty arthritis

A
  • acute severe pain
  • skin over joint red shinny hot and swollen
  • Allodynia on joint
  • Activated: alcohol, diet, starvation, surgery
  • lasts 3-10 days
72
Q

Gout - Clinical features inter critical gout

A
  • Less Time between attacks.
  • Low to no pain.
  • Low-level inflammation causing joint destruction
  • Time for aggressive management strategies
73
Q

Gout - Clinical features Tophi

A

Stone deposits on ear, elbow, big toe

Sign only of gout (pathognomonic

74
Q

Gout - Clinical features tophacious gout

A

High uric levels over prolonged time
more attacks more frequent
permanent joint destruction

75
Q

Gout - diagnosis

A

Synovial fluid aspirate
Elevated serum uric acid
Xray

76
Q

Gout - Management

A

lifestyle changes
NSAID
corticosteroids
Allopurinol

77
Q

Calcium Phyrophosphate deposition disease (CPPD) - Definition

A

Crystal deposition on articular cartilage

chonedrocalcinosis resulting in inflammation and tissue damage

78
Q

Calcium Phyrophosphate deposition disease (CPPD) - Epidemology

A 
65+
Fx
OA
Joint trauma
Diabetes
79
Q

Calcium Phyrophosphate deposition disease (CPPD) - Clinical Features

A 
Acute attacks mimic gout 
one or multiple joints 
Knee
Synovitis 
swelling
Systemic features
80
Q

Calcium Phyrophosphate deposition disease (CPPD) - DDx

A

Tendonitis
RA
OA

81
Q

Calcium Phyrophosphate deposition disease (CPPD) - Diagnosis

A

Synovial fluid analysis

Xray

82
Q

Calcium Phyrophosphate deposition disease (CPPD) - Management

A

Treat symptoms
Cortisone to joint
Paracetamol

Master Semester 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions