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musculoskeletal and rheumatology > Intro To Rheum P1 > Flashcards

Intro To Rheum P1 Flashcards

1
Q

What is rheumatology?

A

Medical specialty dealing with diseases of the musculoskeletal system

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2
Q

What is a joint?

A

Where two bones meet

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3
Q

What are tendons?

A

Cords of strong fibrous Collagen tissue attaches muscle to bone

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4
Q

What are ligaments?

A

Flexible fibrous connective tissue which connects two bones

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5
Q

When looking at joints what four things should you look for?

A

Pain, swelling, stiffness, restricted range of movement

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6
Q

At what time of the day is stiffness of the joints more likely?

A

Morning

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7
Q

What is the term for when only one joint is involved?

A

Monoarthritis

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8
Q

What is the term for when 2-4 joints are involved?

A

Oligoarthritis

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9
Q

What is the term for when over five joints are involved?

A

Polyarthritis

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10
Q

What are some systemic features you should look for when dealing with patients with rheumatological problems

A

Fever, weight loss, malaise

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11
Q

What is malaise?

A

General feeling of discomfort

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12
Q

What is arthritis?

A

Disease of the joints

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13
Q

What are the two major divisions of arthritis?

A

Degenerative joint disease (osteoarthritis)
Inflammatory joint disease

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14
Q

Why is arthritis categorised into two major divisions?

A

As the treatment of these two are completely different

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15
Q

What are the five cardinal features of inflammation

A

Red, pain, hot, swelling, loss of function

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16
Q

What is inflammation?

A

Physiological response to deal with injury or infection

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17
Q

What are the physiological cellular and molecular changes associated with inflammation?

A

Increase blood flow,
migration of leucocytes into tissue
, activation of leucocytes,
cytokines production

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18
Q

Which cytokines are produced an inflammation?

A

TNF alpha, IL-1, IL-6, IL17

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19
Q

What are the three main causes of joint inflammation?

A

Infection, crystal arthritis, immune mediated (autoimmune)

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20
Q

What are the two main infections that can cause joint inflammation?

A

Septic arthritis and tuberculosis

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21
Q

What can cause Crystal arthritis?

A

Gout and pseudogout

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22
Q

What can cause immune mediated joint inflammation?

A

Mainly rheumatoid arthritis

23
Q

What Is an example cause of sterile joint inflammation?

A

Crystal arthritis and immune mediated

24
Q

What can cause septic arthritis?

A

Bacterial infection of a joint typically staphylococcus aureus

25
Q

How might a patient with septic arthritis present in a clinic?

A

Acute red spots painful swollen joint
Monoarthritis
Fever

26
Q

How can you diagnose septic arthritis?

A

Do a joint aspiration and send a sample for urgent gram staining

27
Q

How do you treat septic arthritis?

A

Surgical lavash which is essentially washing out the joint

28
Q

What form of septic arthritis affects multiple joints?

A

Gonococcal septic arthritis

29
Q

 what are the two main types of crystal arthritis

A

Gout and pseudogout

30
Q

What causes gout?

A

Deposition of monosodium urate (Uric acid) around joints

31
Q

What is a risk factor for gout?

A

Hyperuricaemia (high uric acid levels)

32
Q

What causes pseudogout?

A

Caused by deposition of calcium pyrophosphate dehydrate (cppd) crystals in joints

33
Q

What does cppd stand for

A

Calcium pyrophosphate dihydrate

34
Q

What is tophi? 

A

Aggregated deposits of monosodium urate crystals in tissue and develop on hands feet elbows and ears

35
Q

In which condition is tophi seen in

A

 gout

36
Q

Which joint is particularly affected by gout?

A

Metatarsophalangeal joint (big toe)

37
Q

What is the term for when uric acid crystals deposit in the big toe joint?

A

Podagra

38
Q

What blood markers would you look at for gout?

A

Raised c reactive protein (marker of inflammation)
Raised uric aicd

39
Q

What would an x-ray of a patient with chronic gout look like?

A

Would have juxta-articular erosions (look like rat bites)

40
Q

How would you diagnose gout?

A

Joint aspiration & synovial fluid analysis

41
Q

What is rheumatoid arthritis?

A

Chronic autoimmune disease characterised by pain stiffness and symmetrical synovitis of Synovial joint

42
Q

Which joint is particularly affected by rheumatoid arthritis?

A

Proximal inter-phalangeal joint

43
Q

What joint is affected here?

A

Proximal inter-phalangeal joint

44
Q

What areas other than the synovial joints are affected by rheumatoid arthritis?

A

Tenosynovium
Bursa

45
Q

What condition is this picture showing and in which disease do you see this in?

A

Extensor tenosynovitis seen in RA

46
Q

What condition is the image showing and which disease causes this?

A

Olecranon (elbow) bursitis from RA

47
Q

Describe the pattern in RA?

A

Symmetrical,
Poly arthritis,
Affects mainly small joints but affects big joints too

48
Q

What causes osteoarthritis?

A

Wearing away of articular cartilage

49
Q

What are some of the symptoms of osteo arthritis?

A

Joint point (worser with activity)
Joint crepitus (creaking)
Joint enlargement
Limited range of motion

50
Q

What are some signs of osteoarthritis

A

Heberdens nodes and Bouchard nodes

51
Q

What is the term for this sign and which joint is affected in this image?

A

Heberdens nodes & distal interphalangeal joints

52
Q

What is the term for this sign and which joint is affected?

A

Bouchard nodes & proximal interphalangeal joints

53
Q

What are some radiograph in features seen in osteoarthritis?

A

Joint space narrowing
Subchondral bony sclerosis (increased whiteness)
Osetophytes

54
Q

What is the speed of onset of rheumatoid arthritis?

A

Rapid

musculoskeletal and rheumatology (7 decks)

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