Diseases of Musculoskeletal System 1

Question 1

give an example of chronic arthritis?

Answer 1

Osteoarthritis

Rheumatoid Arthritis

Question 2

What are the signs and symptoms of acute arthritis?

Answer 2

Pain
heat
redness
swelling

Question 3

What is Osteoarthritis?

Answer 3

-degenerative joint disease caused by erosion of the articular cartilage (wear and tear)
-Results in the formation of bony spurs and cysts at margins of joints
-

Question 4

What areas are predominantly affected in men and women by osteoarthritis?

Answer 4

women = hands and knees
men = hips

Question 5

What is the cellular basis of Osteoarthritis?

Answer 5

Chondrocytes are the cells which make cartilage.
In OA the chrondrocytes produce interleukin 1 which initiates matrix breakdown.
The chondrocytes also produce lytic enzymes which prevents matrix synthesis.

• cartilage break down (IL1)
• cartilage not made (lytic enzymes)

Question 6

In rheumatoid arthritis who is more affected - men or women?>

Answer 6

Women are 3-5 times more affected

Question 7

what is pannus and effect in rheumatoid arthritis?

Answer 7

Pannus is a sticky, inflammatory exudate between cartilage in the joint space.

RA - Growth of pannus in the joint space causes erosion of the cartilage and it penetrates into the bone causing cyst formation, inflammation and pain

Question 8

What viruses causes Rheumatoid Arthritis?

Answer 8

EBV

Borrelia

Question 9

What is the criteria for rheumatoid arthritis diagnosis?

Answer 9

At least 4 of the following:

1) morning stiffness
2) Arthritis in 3 or more joints
3) Arthritis of hand joints
4) symmetrical arthritis
5) Rheumatoid nodules
6) Serum Rheumatoid factor

Question 10

What are sero negative arthrides?Give examples of Sero-negative arthrides.

Answer 10

Disease lacks rheumatoid factor.

E.g.

1) Ankylosing Spondylitis
2) Reiter’s syndrome (arthritis, conjunctivitis, and urethritis)
3) Psoriatic arthritis
4) Enteropathic arthritis

Question 11

What is Gout?

Answer 11

Excess uric acid in blood deposits in joints.

Question 12

What are the clinical features of gout?

Answer 12

• acute arthritis attacks
• chronic arthritis
• Tophi in various sites
• Gouty nephropathy (uric acid kidney stones)

*tophi - masses of uric acid in joints and other sites

Question 13

What is pyogenic osteomyelitis?

Answer 13

Infection of the bone

Question 14

What are the bacteria that cause infective arthritis?

Answer 14

• Staphylococcus
• Streptococcus
• Gonococcus
• Mycobacteria

Question 15

What is osteoporosis?

Answer 15

• loss of bone density

- loss of bone mass

Question 16

What are the clinical features of osteroporosis?

Answer 16

1) Vertebral fractures
2) Kyphosis (hunch back)
3) Scoliosis (curved spine)

Question 17

What can cause secondary osteoporosis?

Answer 17

1) Endocrine disorders e.g. Hyperparathyroidism, Type 1 diabetes,
2) Neoplasia e.g multiple melanoma
3) Malnuitrition

Question 18

What causes Paget’s disease of the bone/

Answer 18

Paramyxovirus

Question 19

What is the histological hallmark of pagets disease of bone?

Answer 19

mosaic pattern

Question 20

Describe what happens to the bone in pagets disease?

Answer 20

1) Normally bone is formed and renewed by osteoblasts and osteoclasts remove old bone cells (tidy up)
2) in pagets disease the osteoclast activity is inhibited. So Osteoblasts produce new bone which is mixed with old bone forming a “collage of matrix madness” / “mosaic pattern”
3) there is a net effect of gain in bone mass
4) newly formed bone is disordered and architecturally unsound/

Question 21

Who is more affected by pagets disease of the bone?

males or females

Answer 21

Males > females

Question 22

What type of fractures are common with paget’s disease of the bone?

Answer 22

Chalk stick type fractures

Question 23

What type of cells is a benign bone tumour most likely in?

Answer 23

Giant cell tumour - benign

Question 24

What type of malignant bone tumours are most likely?

Answer 24

• Osteosarcoma
• chondrosarcoma
• malignant fibrous histiocytoma

Question 25

What is osteomalacia?

Answer 25

defects in bone mineralization

Question 26

What is the affect of hyperparathyroidism on bone?

Answer 26

1) Hyperparathyroidism leads to excess secretion of PTH.
2) PTH activates osteoclasts to break down bone
3) increased reabsorption of calcium occurs
4) net effect - HYPERCALCAEMIA
5) can lead to osteoporosis due to loss of bone density / mass

Question 27

What is renal osteodystrophy?

Answer 27

Skeletal changes due to chronic renal disease.
CRD causes:
1) increased osteoclastic bone reabsorption
2) Delayed matrix mineralisation
3) Osteosclerosis
4) Growth retardation
5) Osteoporosis

Question 28

What common tumours metastasise to bone?

Answer 28

1) breast
2) prostate
3) lung