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BRS MUSCULOSKELETAL And RHEUM > Bone and Joint Disorders > Flashcards

Bone and Joint Disorders Flashcards

1
Q

What might you expect to see when examining a patient for a fracture?

A

Inability to bear weight
Severe pain
Swelling and point tenderness
Deformity
Scrapes and Abrasions
Wound
Loss of Movement
Loss of sensation

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2
Q

What are the three principles of management for fracture management?

A
  1. Reduce
  2. Hold
  3. Rehabilitate
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3
Q

What does “rehabilitate” involve?

A

Weight bear, move and physio

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4
Q

What does “hold” involve?

A

Plaster, fixation / metal

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5
Q

What is the patient likely to have when a snapping sound is heard, and knee swells up immediately?

A

An anterior cruciate ligament tear

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6
Q

What is the role of the anterior cruciate ligament?

A

To prevent anterior / posterior knee replacement

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7
Q

What symptoms might patients with an ACL tear complain of?

A

Instability, redness, pain, swelling, lack of rotation, pop sensation

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8
Q

What are some physical examinations which can be used to determine whether or not an ACL has been torn?

A

Lachmann’s, Anterior Drawer, Pivot Shift

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9
Q

What are some short term management techniques for bone and joint injuries?

A

PRICE
Protect
Rest
Ice
Compress
Elevate

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10
Q

What factors does the management of an ACL Rupture depend on?

A

Depends on factors to do with the patient like their age, physical activity status, whether they perform movements which requires the ACL

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11
Q

Why does the ACL not heal well?

A

It has poor vascularisation

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12
Q

What condition is the patient likely to have if they hear a loud snap at the back of their ankle, alongside a very sharp pain?

A

An injured achilles tendon

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13
Q

What are some examination findings which would be consistent with a ruptured achilles tendon?

A

Difficulty walking, unable to perform heel raises, thickening, tenderness

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14
Q

What would a patient with a ruptured achilles tendon expect to see when they dangle their feet off the end of the bed?

A

The foot it held in dorsiflexion

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15
Q

What are the four stages of tendon healing?

A

Inflammatory, Reparative, remodelling (consolidation and maturation)

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16
Q

What are some operation complications that may arise from a ruptured achilles tendon?

A

DVT (deep vein thrombosis)
Infection
Prolonged immobility
Neurovascular injury
Tendon rerupture
Ankle stiffness
Pressure sores from plaster
Reduced strength

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17
Q

What are the differential diagnoses for groin pain?

A

Hip fracture
Lumbar Radiculopathy (sciatica)
Arthritis
Hernia
Infection
Hip Labrum tear

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18
Q

What drugs increase the risk of osteoporosis?

A

Glucocorticoids
Anti-epileptic
Anti-coagulants (Heparin)

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19
Q

What lifestyle factors increase the risk of OP?

A

Excessive alcohol
Smoking
Physical Activity
Low Body Weight

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20
Q

Which endocrine disorders increase the risk of OP?

A

Hypogonadism
Hyperthyroidism
Cushings Disease
Growth Hormone deficiency
Hyperparathyroidism

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21
Q

Which other disorders increase the risk of OP?

A

Malnutrition
Anorexia
Chronic inflammatory bowel disease

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22
Q

What is one of the first signs of OP?

A

Kyphosis - stooped back

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23
Q

What characterises a stooped back?

A

weakening of bones

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24
Q

At what stage do women have an increased risk of OP?

A

After menopause as there is a lack of oestrogen

25
Q

What affect does oestrogen have on bone loss?

A

It slows it down, and also improves the absorption and retention of calcium

26
Q

What are some causes of OP?

A

Long term usage of corticosteroids
Certain medications for inflammatory conditions
Family History
Low BMI
Drinking and Smoking

27
Q

Which scan is used to measure bone density?

A

DEXA scan

28
Q

A T score of what indicates Osteopenia?

A

-1 to -2.5

29
Q

A T score of what indicates Osteoporosis?

A

Less than -2.5

30
Q

What is osteopenia?

A

Pre-osteoporosis

31
Q

What is the first-line treatment for OP?

A

Bisphosphonates

32
Q

Why do bisphosphonates work as an anti-OP drug?

A

They prevent bone reabsorption by stopping osteoclasts from working

33
Q

What hormone can patients with OP be given?

A

Parathyroid hormone as it stops bone thinning

34
Q

What are SERMs?

A

Selective Oestrogen Receptor Modulators - have similar effects to oestrogen by helping to maintain bone density

35
Q

What characterises Osteomalacia?

A

Inadequate mineralisation of the bone, causing the bone to soften

36
Q

What causes osteomalacia?

A

Vitamin D deficiency

37
Q

What can cause vitamin D levels to be low?

A

Insufficient dietary intake, faulty vitamin D metabolism, renal tubular acidosis, malnutrition

38
Q

How can osteomalacia be diagnosed?

A

Very low vitamin D levels, alongside psuedofractures and protrusion acetabula on radiographic images

39
Q

How can you treat nutritional osteomalacia?

A

increased dietary intake
Increase outdoor time
supplementation of vitamin

40
Q

What are the two inflammatory markers which are commonly tested for?

A

C Reactive Protein
ESR - Erythrocyte sedimentation Rate

41
Q

Which bacterial hip infection can be treated with antibiotics before having to be washed out?

A

Gonococcus

42
Q

What is meant by aspiration of a joint?

A

Using a needle to remove the pus within a joint, in order to remove the infection from it

43
Q

What is osteomyelitis?

A

Infection of the bone

44
Q

what are the three categories of possible causes of a limping child?

A

Inflammation, infection, trauma

45
Q

What are the common hip conditions which a 10-16 year old patient might present with?

A

Slipped femoral epiphysis
Avulsion fractures
Osteomyelitis

46
Q

What are the common hip conditions which a 4-10 year old patient might present with?

A

Transient Synovitis
Osteomyelitis / septic arthritis

47
Q

At what age is transient synovitis common?

A

up to 10 years of age

48
Q

What conditions might patients under the age of 4 suffer from?

A

Juvenile idiopathic arthritis
Non-accidental injury
Transient Synovitis
Osteomyelitis

49
Q

What is transient synovitis?

A

an inflammation in the hip joint that causes pain, limp and sometimes refusal to bear weight

50
Q

What are the Kocher Criteria for Septic Arthritis?

A
  1. Must be non-weight bearing
  2. Fever
  3. High ESR
  4. High White Blood Cell Count
51
Q

Between septic arthritis and transient synovitis, which should be treated with antibiotics and aspiration?

A

Septic arthritis

52
Q

What is the treatment for transient synovitis?

A

Rest and Observation
Keep patient under close observation
Pain killers for pain

53
Q

What is the treatment for septic arthritis?

A

Multiples aspirations and irrigations, culture pus sample and the give narrow spectrum antibiotics

54
Q

What are the cardinal signs of inflammation?

A

Swelling, redness, heat, painful

55
Q

How does a bacterial infection change the colour the fluid in a joint?

A

Colour - more cloudy, darker

56
Q

How does a bacterial infection change the consistency of the fluid in a joint?

A

Increase viscosity, large volumes of effusions from swellings

57
Q

How will changes in the joint fluid following infections be reflected in blood tests

A

Raised inflammatory markers - White cell count, ESR, CRP

58
Q

What are the three different routes bacteria can use to spread?

A

Inoculation, blood, from bone

59
Q

What is the treatment for an infected joint?

A

Aspirate
Culture
Antibiotics
If confirmed infection - washout with keyhole arthroscopy
Continue antibiotics

BRS MUSCULOSKELETAL And RHEUM (17 decks)

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