CBL cards 2 Flashcards
“Pathogenesis and Pathological Changes in RA”
Autoimmune disorder, Synovial inflammation and hyperplasia, Formation of pannus (inflammatory tissue) eroding cartilage and bone, Destruction of articular structures, Systemic manifestations including rheumatoid nodules\
Investigations for RA Diagnosis
Rheumatoid factor (RF), Anti-cyclic citrullinated peptide (anti-CCP) antibodies, Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), Imaging (X-ray, ultrasound, MRI), Synovial fluid analysis (for inflammatory markers)\
Management of RA
Multidisciplinary team (MDT) involvement (rheumatologist, physiotherapist, occupational therapist), Disease-modifying antirheumatic drugs (DMARDs) - methotrexate, sulfasalazine, biologic agents, Nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief, Corticosteroids for acute flares, Physical therapy and exercise\
Relationship Between Psoriasis and Joint Disease
Psoriatic arthritis (PsA) is a common manifestation, Both conditions share underlying immune dysregulation and genetic predisposition\
Signs and Symptoms of Seronegative Spondyloarthropathies
Inflammatory back pain, Enthesitis (inflammation at tendon or ligament insertion points), Peripheral arthritis, Extra-articular manifestations (e.g., uveitis, psoriasis, inflammatory bowel disease)\
HLA B27 and Seronegative Spondyloarthropathies
Genetic marker associated with increased risk, Presence in many individuals with seronegative spondyloarthropathies, Exact role in disease pathogenesis not fully understood\
Dermatological Features of Psoriasis
Red/Violaceous, scaly plaques with well-defined borders, Commonly found on extensor surfaces (elbows, knees), scalp, and nails, Auspitz sign (pinpoint bleeding when scales are removed)\
Treatment Options for Psoriasis
Topical corticosteroids, Topical vitamin D analogs, Phototherapy (UVB, PUVA), Systemic agents (methotrexate, cyclosporine, biologics\
Causes of Vitamin D Deficiency
Inadequate sunlight exposure, Poor dietary intake, Malabsorption disorders, Renal dysfunction, Altered metabolism due to medications or liver disease\
Clinical Features of Osteomalacia
Bone pain and tenderness, Muscle weakness and fatigue, Fractures (especially in weight-bearing bones)\
Calcium and Phosphate Homeostasis
Regulated by parathyroid hormone (PTH), calcitonin, and vitamin D, PTH increases serum calcium by stimulating bone resorption and renal reabsorption, Vitamin D promotes intestinal absorption of calcium and phosphate\
Pathology, Investigation, and Management of Osteomalacia
Histological evidence of undermineralized bone on bone biopsy, Blood tests showing low serum calcium and phosphate, elevated alkaline phosphatase, Treatment involves correcting underlying cause and vitamin D supplementation\
Red Flags in Clinical Presentation for Back Pain
History of trauma, Age >50 or <20 years, History of cancer, Constitutional symptoms (fever, weight loss), Neurological deficits or bowel/bladder dysfunction\
A-E Assessment of Acutely Unwell Patient
Airway assessment, Breathing assessment, Circulation assessment, Disability assessment (neurological), Exposure (undressing for full examination)\
Compartment Syndrome
Increased pressure within a closed anatomical compartment impairs circulation and tissue perfusion, Common in limbs, particularly lower leg and forearm, Leads to ischemia, tissue necrosis, and nerve damage if untreated\
Management of Compartment Syndrome
Urgent fasciotomy (surgical decompression), Continuous monitoring of compartment pressures, Prevention of complications like infection and contractures\
Complications of Fractures
Soft tissue injury (contusions, lacerations), Vascular injury leading to ischemia or hemorrhage, Compartment syndrome due to increased pressure within a compartment\
Symptoms and Signs of Acute Limb Ischaemia
Sudden onset severe pain, Pallor, Pulselessness, Paresthesia, Paralysis, Flexion of the compartment causes pain as pressure increases\
Terminology for Describing Fractures
Type (e.g., transverse, oblique, comminuted), Location (e.g., proximal, distal, shaft), Alignment (e.g., displaced, non-displaced), Open or closed (compound or simple)\
Missed Diagnoses and Medical Errors
Lack of thorough history-taking or examination, Misinterpretation of test results, Confirmation bias or anchoring, Communication errors between healthcare providers\
Impact of Migrant Journeys on Health Access
Language and cultural barriers, Limited access to healthcare facilities during migration, Trauma and stress affecting physical and mental health, Legal and social factors influencing access to healthcare services\
