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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

25
Effects of osteoporosis
Increase bone fracture risk Vertebrae - height loss, kyphosis and scoliosis, nerve root compression (back pain)
26
Why might men be lower risk for osteoporosis?
Higher peak bone mass
27
% women at 50 and 80 osteoporosis
15% at 50 40% at 80
28
Osteoporosis
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
Risks of HRT
Increased breast and endometrial cancer risk Increased DVT risk Combine with progestrogen to reduce risks
30
Bisphosphonate action
Poisons osteoclasts and reduces their numbers -> less bone removal
31
Issues with bisphosphonates
MRONJ risk
32
Symptoms of joint disease
Pain Immobility/stiffness Loss of function
33
Swelling - joint disease
Fluctuant - lots of fluid infused into joint Bony - osteophytes form at joint edges Synovial enlargement
34
Crepitus
Noise made by bone ends moving, usually associated by loss of usual cartilaginous covering of bone ends
35
Investigations for joint diseases such as gout and osteoarthritis
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
Acute monoarthropathies
Acute arthritis of a single joint Commonly caused by infection (septic arthritis), crystal arthropathy (gout) These can be the initial stage of polyarthritis
37
Gout
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
Gout incidence men/women
More common in men until menopause, then equal
39
Treatment for gout
NSAIDs
40
Gout dental relevance
Avoid apirin - interferes with uric acid removal Drug treatments may give oral ulceration
41
Osteoarthritis
Degenerative joint disease Weight bearing joints - hips and knees NOT wear and tear - cartilage repair dysfunction
42
Osteoarthritis symptoms
Pain Brief morning stiffness Slowly progresses over years
43
Signs of osteoarthritis
Radiographs - loss of joint space as reduced cartilage, subchondral sclerosis, osteophyte lipping at joint edge Joint swelling and deformity
44
Treatment for osteoarthritis
Nothing to alter disease progression Pain improved by increasing muscle strength, weight loss, walking aids, NSAIDs, joint replacement
45
Dental relevance of osteoarthritis
TMJ can be involved Difficulty accessing care Chronic NSAID use - oral ulceration, bleeding tendency
46
Connective tissue diseases
Autoimmune - target of inflammation is tissues themselves Vasculitic - target is blood vessels
47
Autoimmune connective tissues diseases
Systemic lupus erythematosis (SLE) Systemic sclerosis Sjogrens syndromome Undifferentiated connective tissue disease
48
Categorisation of vasculitic diseases
Categorised by size of vessel involved Large - giant cell arteritis Medium - Polyarteritis nodosa, Kawasaki disease Small - Wegener's granulomatosis
49
Management of vasculitic disease
No cure as cause not clear NSAIDs Immune modulating treatment Last resort prednisolone systemic steroids to reduce inflammatory process, long term not advised
50
Antibodies commonly found in autoimmune disease
Anti nuclear antibody Anti double strand DNA Anti ro antibody Anti La antibody
51
Discoid lupus
Tissue changes without blood autoantibodies Largely same tissue involvement, more localised, seen in skin and mouth, looks like lichen planus
52
Systemic lupus erythematosis
Circulating ANA, dsDNA, ARo antibodies and organ changes Joints, skin, kidneys, muscles, blood, CVS, renal and CNS
53
Epilepsy
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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