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BDS3 > Diseases of Human Systems > Flashcards

Diseases of Human Systems Flashcards

1
Q

Arthritis

A

Inflammation of joints

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2
Q

Arthrosis

A

Non-inflammatory joint disease

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3
Q

Arthralgia

A

Joint pain

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4
Q

Disorders of bone metabolism

A

Osteomalacia
Osteoporosis

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5
Q

3 main features of bone - mineralised connective tissue

A

Load bearing
Dynamic - continuously changing, ability to adapt to stresses
Self repairing

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6
Q

Osteoclasts

A

Resorb bone

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7
Q

Osteoblasts

A

Deposit bone
Lay down and osteoid matrix, which is mineralised to become bone
Process takes 3-6m

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8
Q

What are the requirements for normal bone deposition?

A

Calcium
Phosphate
Vit D

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9
Q

Exchangeable calcium

A

Stored in bone
Moves from bon into the extracellular fluid
Absorbed from the gut into extracellular fluid
Lost through gut and urine

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10
Q

Blood calcium

A

Must be maintained at a very precise level as it is involved in nerve and muscle function

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11
Q

How is location of calcium moderated?

A

Bone and ECF, using parathyroid hormone

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12
Q

What is the effect of a low calcium diet?

A

-> Reduction in plasma Ca -> increases parathyroid hormone ->
- Increased Active vitD - increases intestinal Ca absorption
- Decreased urinary Ca - increased conservation of dietary Ca
- Increased bone calcium release - increased bone loss
–>Restoration of normal plasma Ca

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13
Q

What can affect parathyroid function and therefore hormone levels?

A

Accidentally removed in thyroid surgery
Parathyroid tumour

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14
Q

3 actions of parathyroid hormone

A

Maintains serum calcium levels
Increases calcium release from bone
Reduces renal calcium excretion

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15
Q

Hypoparathyroidism

A

Occurs when there is insufficient parathyroid hormone
Leads to low serum calcium

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16
Q

Hyperparathyroidism

A

Primary occurrence - problem with the gland itself, could be caused by parathyroid tumours, results in high serum calcium and inappropriate activation of osteoclasts
Secondary occurrence - caused by low serum calcium , high parathyroid hormone levels activate osteoclasts appropriately, maintain serum calcium level

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17
Q

Effect of both hypoparathyroidism and hyperparathyroidism

A

Bone resorption - appears as radiolucencies on radiographs

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18
Q

Vitamin D effect on bone health

A

Vitamin D (from sunlight or diet such as orange juice, fish) absorbed into blood, through liver and kidneys to be output as 1,25 dihydrocycoecalciferol necessary for calcium absorption in the gut
Lack of vit D can cause poor bone health

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19
Q

Drugs that interfere with vitamin D absorption

A

Phenytoin and carbamazepine - epilepsy

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20
Q

Osteomalacia

A

Normal osteoid matric laid down, but not properly mineralised - softer bone
(Rickets if during bone formation)

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21
Q

What is alkaline phosphotase used to measure?

A

Bone turnover - very high when there is a problem with calcium levels

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22
Q

Osteoporosis

A

Bone matrix and mineralisation correct, but reduced amounts of both leading to reduced bone mass
Age related, normal finding

23
Q

Osteoporosis risk factors

A

Age
Females
Endocrine
Genetic
Inactivity
Smoking
Excess alcohol
Poor dietary calcium
Steroid
Antiepilectics

24
Q

Peak bone mass

A

24-35

25
Q

Effects of osteoporosis

A

Increase bone fracture risk
Vertebrae - height loss, kyphosis and scoliosis, nerve root compression (back pain)

26
Q

Why might men be lower risk for osteoporosis?

A

Higher peak bone mass

27
Q

% women at 50 and 80 osteoporosis

A

15% at 50
40% at 80

28
Q

Osteoporosis

A

Build maximal peak bone mass - exercise, calcium
Reduce rate of bone mass loss - exercise and calcium, reduce hormone related effects with HRT
Bisphosphonates - osteoporosis prevention drugs

29
Q

Risks of HRT

A

Increased breast and endometrial cancer risk
Increased DVT risk
Combine with progestrogen to reduce risks

30
Q

Bisphosphonate action

A

Poisons osteoclasts and reduces their numbers -> less bone removal

31
Q

Issues with bisphosphonates

A

MRONJ risk

32
Q

Symptoms of joint disease

A

Pain
Immobility/stiffness
Loss of function

33
Q

Swelling - joint disease

A

Fluctuant - lots of fluid infused into joint
Bony - osteophytes form at joint edges
Synovial enlargement

34
Q

Crepitus

A

Noise made by bone ends moving, usually associated by loss of usual cartilaginous covering of bone ends

35
Q

Investigations for joint diseases such as gout and osteoarthritis

A

Radiographs
Blood tests - inflammatory markers such as C reactive protein, markers for autoimmune disease (such as rheumatoid factors, extractable nuclear antigens, anti DS-DNA, anti nuclear antibody)
Arthroscopy - view inside joint and biopsy soft tissue swelling

36
Q

Acute monoarthropathies

A

Acute arthritis of a single joint
Commonly caused by infection (septic arthritis), crystal arthropathy (gout)
These can be the initial stage of polyarthritis

37
Q

Gout

A

Acute arthritis of a single joint, can be due to infection
Uric acid crystals deposited in the joint, causing irritation leading to swelling and inflammation
Severe pain
Caused by high blood uric acid

38
Q

Gout incidence men/women

A

More common in men until menopause, then equal

39
Q

Treatment for gout

A

NSAIDs

40
Q

Gout dental relevance

A

Avoid apirin - interferes with uric acid removal
Drug treatments may give oral ulceration

41
Q

Osteoarthritis

A

Degenerative joint disease
Weight bearing joints - hips and knees
NOT wear and tear - cartilage repair dysfunction

42
Q

Osteoarthritis symptoms

A

Pain
Brief morning stiffness
Slowly progresses over years

43
Q

Signs of osteoarthritis

A

Radiographs - loss of joint space as reduced cartilage, subchondral sclerosis, osteophyte lipping at joint edge
Joint swelling and deformity

44
Q

Treatment for osteoarthritis

A

Nothing to alter disease progression
Pain improved by increasing muscle strength, weight loss, walking aids, NSAIDs, joint replacement

45
Q

Dental relevance of osteoarthritis

A

TMJ can be involved
Difficulty accessing care
Chronic NSAID use - oral ulceration, bleeding tendency

46
Q

Connective tissue diseases

A

Autoimmune - target of inflammation is tissues themselves
Vasculitic - target is blood vessels

47
Q

Autoimmune connective tissues diseases

A

Systemic lupus erythematosis (SLE)
Systemic sclerosis
Sjogrens syndromome
Undifferentiated connective tissue disease

48
Q

Categorisation of vasculitic diseases

A

Categorised by size of vessel involved
Large - giant cell arteritis
Medium - Polyarteritis nodosa, Kawasaki disease
Small - Wegener’s granulomatosis

49
Q

Management of vasculitic disease

A

No cure as cause not clear
NSAIDs
Immune modulating treatment
Last resort prednisolone systemic steroids to reduce inflammatory process, long term not advised

50
Q

Antibodies commonly found in autoimmune disease

A

Anti nuclear antibody
Anti double strand DNA
Anti ro antibody
Anti La antibody

51
Q

Discoid lupus

A

Tissue changes without blood autoantibodies
Largely same tissue involvement, more localised, seen in skin and mouth, looks like lichen planus

52
Q

Systemic lupus erythematosis

A

Circulating ANA, dsDNA, ARo antibodies and organ changes
Joints, skin, kidneys, muscles, blood, CVS, renal and CNS

53
Q

Epilepsy

A

Group of conditions caused by abnormal discharge of neurons in the brain
Associated with GABA levels in brain, leading to abnormal cell to cell message propagation -> less stimulation for a neuron to pass a message on

BDS3 (20 decks)

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