Alterations of MSK: metabolic rheumatic disorders

Question 1

Osteopenia

Answer 1

• Imbalance between formation and breakdown
• decreased mineralization
• osteoblasts
• osteoclasts
• seen in perimenoposual and post menopausal-estrogen circulating helps w/ bone strength
• precursor to osteoperosis

Question 2

Osteoclasts

Answer 2

-bone breaking cells

Question 3

Osteoblasts

Answer 3

-bone building cells

Question 4

Osteoporosis

Answer 4

• decreased bone mineral density (over 2.5)
• decreased cancellous (spongy) bone strength
• decreased bone matrix and mineralization
• bone resorption>bone formation

Question 5

Osteomalacia

Answer 5

• in adults
• bone is not mineralized properly
• caused by insufficient Ca absorption, phosphate
• Results in bone pain and tenderness, fractures

Question 6

Paget R

Answer 6

• regions of excessive bone turnover
• new bone is disorganzied
• deformation and fractures are common
• Osteoclastic activity and bone destruction and repair involving long bones, spine, pelvis, and cranium, jaw, clavicle
• See correlation all the way back to parathyroid

Question 7

Rheumatoid Arthritis

Answer 7

• Autoimmune disorder
• synovial inflammation and joint architecture destruction
• possible genetic predisposition
• Antibody against IgG fragments in most
• Exacerbations and remissions

Question 8

Systemic Lupus Erythematosus (SLE)

Answer 8

• Type III hypersensitivty
• autoantibodies against self molecules in plasma, cytoplasm, cell surface, antinuclear antibodies (ANA)
• Butterfly rash
• SLE can damage any tissue

Question 9

Systemic Sclerosis (Scleroderma)

Answer 9

• autoimmune disease
• fibroblast activation
• extensive fibrosis throughout the body
• affects skin and internal organs
• limited and diffuse clinical subsets

Question 10

Spondyloarthropathies

Answer 10

• multisystem inflammatory disorders
• sacrolittis-pathologic halmark
• inflammation begins at insertions of tendons and ligaments into bone
• ankylosing spondylitis

Question 11

Reactive Arthritis

Answer 11

• Sterile joint inflammation caused by previous GI infections or STI (salmonella, shigella, campylobacter, yersinia, chlamydia)
• joints not infected at the time of inflammation

Question 12

Reiter syndrome

Answer 12

-arthritis, nongonococcal urethritis, or cervicitis and conjuctivitis

Question 13

Enteropathic arthritis

Answer 13

-associated w/ inflammatory bowel disease or enterogenic bacteria

Question 14

Osteoarthritis

Answer 14

-Degenerative joint disease
-idiopathic or primary OA
-Secondary OA-congentital
-damaged joint cartilage tries to heal itself
-Cartilage contains more water, less collagen
“wear and tear”

Question 15

Gout syndrome

Answer 15

• Increased serum uric acid-crystals precipitate in the joint-inflammation
• acute gouty arthritis
• tophi-accumulation of crystalline deposits
• gouty nephropathy
• uric acid kidney stones