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MSK > Conditions MSK (FCM) > Flashcards

Conditions MSK (FCM) Flashcards

1
Q

What types of things might you look out for in a basal skull fracture? (4 things)

A
  1. Periorbital ecchymosis ( racoon eyes)
    2.Battle sign (bruising behind the ears
  2. Hemotympanum (Blood in the middle ear)
  3. Ottorhea/ rhinorrhoea (bloody discharge mixed with clear CSF)
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2
Q

What would you find on history for someone with inflammatory joint conditions? (6 things)

A
  1. morning stiffness >1 hour
  2. Swelling/ erythema
  3. Stiffness
  4. Better with activity
  5. ESR and CRP elevated
  6. May help with steroids + cDMARD’s
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3
Q

Name 4 inflammatory joint conditions

A
  1. Rheumatoid arthritis
  2. Psoriatic arthritis
  3. Reactive arthritis
  4. Lupus
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4
Q

What would you find on history for someone with non-inflammatory joint conditions? (6 things)

A
  1. Morning stiffness <1 hour
  2. Less swelling
  3. Pain more than stiffness
  4. Worse with activity
  5. ESR and CRP normal
  6. Not helped with cDMARD’s
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5
Q

Name a non-inflammatory joint condition

A

Osteoarthritis
- weight bearing joints (knees, hips)

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6
Q

What is rheumatoid arthritis and what joints are typically affected?

A

An autoimmune inflammatory joint disease

Generally poly arthritis (many joints affected- usually wrist, MCP and PIP joints)
Symmetrical
progresses to joint destruction and deformity
Systemic signs

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7
Q

What bones do OA not affect and what bones do RA not affect?

A

OA:

OA affects the DIP’s and PIP bones
Not MCP’s

RA:
RA affects the PIP’s and MCP bones
Not DIP’s

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8
Q

What is Psoriatic arthritis? How does it present (5 things)

A

Chronic inflammatory disease associated with psoriasis

-The knee and DIP’s are common areas of disease.
- Non symmetrical (mono/oligoarthritis)
-Pitting of the nails
-Dactylitis (entire digit is swollen)
-Enthesitis (swelling where bone attaches to tendon)

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9
Q

Is CCP, positive or negative in Psoriasis arthritis?

A

Negative !
Otherwise this would be RA

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10
Q

How do you manage Sjrogens disease? (3 things)

A

Conservative management

  • Eyedrops (Hypromellose)
  • Sialogogues (makes them salivate)
  • Punctal plugs (plugs in the tear glands to stop the tears draining)
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11
Q

What is Sjrogens disease? What are some symptoms? (7 things)

A

An immune disorder that affects how well the body is able to produce fluids. It is characterised by dry eyes and a dry mouth

Inflammatory condition.

Sx:
- Dry eyes
- Dry mouth
- Rash after being in the sun
- Muscle pain
- Swelling
- Vaginal dryness
- Fatigue

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12
Q

What is reactive arthritis? how does it usually present?

A

An inflammatory arthritis that occurs after exposure to a GI or GU infection

Classic triad:
“I can’t see, pee, or climb a tree”
1. Arthritis
2. Uveitis
3. Urethritis

  • Large joints
  • Systemic sx. fever, malaise etc.
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13
Q

What is Polymyalgia rheumatica (PMR)?

A

Inflammatory condition causing PAIN in the hip and shoulder girdles.
It tends to be episodic

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14
Q

How is PMR managed?

A
  1. 15mg Prednisolone OD for 3/52
  2. Reduce to 12.5mg for 3/52 then 10mg OD for 4-6/52 then reduce by 1mg every 4-8 weeks.
  3. Advise that steroid’s should be continued for 1-2 years.

This should resolve ALL the symptoms.

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15
Q

What do you need to ask someone with PMR? (4 things)

A
  1. Any visual changes?
  2. Any headaches?
  3. Any scalp tenderness?
  4. headaches?? **

This is because GCA is associated with PMR and can cause permanent vision loss. (These patients need high dose steroids to save vision)

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16
Q

What is the main differences between PMR and Polymyositis?

A

PMR causes shoulder and hip girdle pain
and polymyositis causes shoulder and hip girdle weakness !

PMR - Causes raised ESR
Polymyositis causes raised CK

17
Q

What is Polymyositis? How do es it present and what would you expect on bloods? How is it diagnosed ? What is the treatment ?

A

Inflammatory condition of the muscles. Causes weakness in the proximal muscles.

Sx:
- Trouble getting out of their chair
- Trouble brushing their hair
- Typically >40yrs old

Ix:
- Very raised CK

Dx:
- EMG (Electromyography)
- Muscle biopsy ** (definitive diagnosis)

Tx:
- Steroids

18
Q

What is juvenile arthritis?

A

Arthritis in patients <16yrs +>6 weeks old.

Characterised by joint pain/swelling (commonly in knees) + intermittent spiking fevers (1-2 spikes per day)

19
Q

What condition is characterised by trigger points ?

A

Fibromyalgia

  • There are 18 trigger points. patient’s need <11 to have the condition
20
Q

What is Fibromyalgia? How is it treated?

A

Long term condition that causes pain all over the body.
It is treated via symptomatic relief

21
Q

What is Systemic lupus erythematosus(SLE)?

A

A chronic multi- system disorder. The immune system attacks its own tissues which causes many symptoms

22
Q

Symptoms of SLE (use mnemonic “imdamnsharp)

A

I - Immunoglobulins present
M- Malar rash

D- Discoid rash
A- Anti nuclear antibodies (ANA)
M- Mucositis
N- Neurological disorders

S- Serositis
H- Haematologic disorders
A- Arthritis
R- Renal disorders
P- photophobia

23
Q

What would you expect to find on examination for osgood schlatter’s disease? (2 things)

A
  • Point tenderness on the tibial tuberosity
  • Pain worsens with activity
24
Q

What is the most common ankle sprain ?

A

Anterior talofibular (ATF) ligament

25
Q

What is plantar fasciitis and how does it present? (5 things)

A

This is the most common cause of heel pain. Commonly caused by obesity, physical activity, pregnancy, occupation or foot structure.

Sx:
- Heel pain
- Stabbing pain on the bottom of the foot
- Worse when walking bare foot
- Most painful during the “first few steps” in the morning
- Pain relieved by rest

26
Q

What is Mortons neuroma ? How would it present?

A

Pain between the 3rd and 4th toes. Described as “walking on marbles”

  • Pain when squeezing toes
  • Mulder sign
    -Mulder click
27
Q

What is the first line for fibromyalgia?

A

Non pharmacological
- ptx education
- Increase exercise
- CBT

Pharmacology:
- Amitriptyline (1st line)

28
Q

How do you differentiate Septic arthritis from cellulitis?

A

Septic arthritis is found in the joint whereas Cellulitis can be found on any part of the limb.
Also people tend to not get systemic. symptoms with cellulitis

29
Q

List some risk factors for Osteomyelitis. (5 things)

A
  1. Sickle cell disease
  2. Diabetes
  3. Recent surgery
  4. IV drug misuse
  5. HIV infection
30
Q

How would you manage acute (5 things) and prophylactic (1 thing) gout?

A

ACUTE:
1. NSAID’s (technically 1st line)
2. Colchicine 500mg BD or Prednisolone 1st line meds.

  1. Rest
  2. Elevate the foot
  3. ICE

Note: Never give allopurinol during an acute attack.

  • Also cannot give steroid injection if theres infection.

PROPHYLAXIS:
- Allopurinol OD
This is for people who get gout >2-3 times yearly.

31
Q

How is pseudo gout treated?

A
  1. NSAID’s
  2. or steroids
  • These have positively birefringent crystals
32
Q

Which is worse, osteopenia or osteoporosis?

A

Osteoporosis

33
Q

How does osteoarthritis present? +what would you see on X-ray (5 things )

A
  1. Activity related joint pain

2.Morning stiffness no longer than 30mins

X-ray:
3.Joint space narrowing

  1. Osteophytes
  2. subchondral bone thickening and/or cysts
34
Q

X-ray findings of Rheumatoid arthritis? (4 things)

A
  1. Joint destruction and deformity
  2. Soft tissue swelling
  3. Periarticular osteopenia (earliest signs of RA)
  4. Boney erosions
35
Q

Symptoms for a blow out fracture? (5 things)

A
  1. Diplopia (to differentiate from other things)
  2. Bruising
  3. Tenderness and swelling around the eye
  4. Redness of the eye
  5. numbness of the cheek, nose or teeth
36
Q

What gram positive and what gram negative bacteria lead to septic arthritis?

A

Pos+
- Staphylococcus aureus

Neg-
-Neisseria gonorrhoeae

37
Q

what population are likely to isolate Pseudomonas aeruginosa in a diagnosis of septic arthritis ?

A

IVDU

38
Q

How does pages disease of the bone present? (4 THINGS)

A
  • Cotton wool appearance of the skull
  • bone aches and joint pain
  • increased head size
    -BLOODS: normal PTH, calcium and increased ALP

MSK (4 decks)

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