Disease of Bones and Joints

Question 1

How is bone remodelled?

Answer 1

1. Activation of osteoclasts
2. Resorption of bone
3. Death of osteoclast
4. Formation of new matrix by osteoblasts
5. Mineralisation of new matrix

Question 2

What can go wrong w/ bones?

Answer 2

1. Matrix formation
2. Mineralisation problems
3. Turnover problems

Question 3

Bone matrix disorder - what is it and give example?

Answer 3

Mutation in collagen

Type 1 e.g osteogenesis imperfecta

Question 4

Cartilage matrix formation disorder example?

Answer 4

Achondroplasia - autosomal dominate
Failure of cartilage maturation at the growth plate
Caused mutation fibroblast growth receptor

Question 5

Example of disease of mineralisation?

Answer 5

Osteomalacia/ Ricketts

Deficiency vitamin D or Ca

Question 6

Give example of bone remodelling problem?

Answer 6

Osteoporosis - increased porosity in bone - bone resorb> bone formation

Question 7

Risk factor osteoporosis?

Answer 7

LAN GAH

Lifestyle, age, nutrition, genetic, activity, hormonal

Question 8

Which type of bone is lost in osteoporosis?

Answer 8

Trabecular - greater SA

Question 9

Complications of osteoporosis?

Answer 9

Fragility fracture, kyphosis, loss of height

Question 10

Tx of osteoporosis

Answer 10

Bisphosphonate - inhibition bone resorption

Question 11

Name disease of abnormal bone turnover?

Answer 11

Pagets - excessive turnover

Question 12

How to tx Paget;s

Answer 12

Bisphosphonates

Question 13

Give example of bone infection

Answer 13

Osteomyelitis - complication compound fracture - necrosis of bone fragments

Question 14

Name origin of tumour in bone?

Answer 14

Most are metastases - lung, breast, prostate, thyroid, kidney

Question 15

What is a chondrogenic tumour

Answer 15

most benign = osteochondroma
some malignant (40%) = chondrosarcoma

Question 16

Example of malignant bone tumour?

Answer 16

Osteosarcoma, chondrosarcoma, Ewings sarcoma

Question 17

Give example of joint infections?

Answer 17

1. Septic arthritis - trivial cause but can be very painful

2. Crystal arthropathies - gout - urate crystals secondary to raised serum uric acid

Question 18

What is chronic inflammatory arthritis?

Answer 18

Autoimmune arthritis e.g rheumatoid

Question 19

What is osteoarthritis?

Answer 19

Common degenerative disease - erosion of cartilage

Question 20

Feature of osteoarthritis

Answer 20

Localised pain - increase w/ function, decreased range of movement, swollen and stiff joints

Question 21

Management osteoarthritis

Answer 21

NSAIDS, steroid, physio, surgery

Question 22

How tx gout?

Answer 22

NSAID, steroid, urate lowering drugs