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Year 2 MIS > Introduction to the Diseases of the Musculoskeletal System > Flashcards

Introduction to the Diseases of the Musculoskeletal System Flashcards

1
Q

Medical terms that begin with chrond relates to what?

1 - bone
2 - cartilage
3 - muscle
4 - joints

A

2 - cartilage

- chondrocytes are precursors for cartilage

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2
Q

Medical terms that begin with osteo relates to what?

1 - bone
2 - cartilage
3 - muscle
4 - joints

A

1 - bone

- comes from osteon

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3
Q

Medical terms that begin with my/myo relates to what?

1 - bone
2 - cartilage
3 - muscle
4 - joints

A

3 - muscle

- comes from myoblasts

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4
Q

Medical terms that begin with arth relates to what?

1 - bone
2 - cartilage
3 - muscle
4 - joints

A

4 - joints

- arthrosis means joint

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5
Q

Medical terms that begin with itis relates to what?

1 - inflammation
2 - cartilage
3 - muscle
4 - joints

A

1 - inflammation

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6
Q

Medical terms that begin with algia relates to what?

1 - inflammation
2 - cartilage
3 - muscle
4 - pain

A

4 - pain

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7
Q

What does tendonitis refer to?

A
  • inflammation of a tendon
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8
Q

What does bursitis refer to?

A
  • inflammation of a bursae
  • bursae = closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body
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9
Q

What does enthesitis refer to?

A
  • inflammation of entheseal

- entheseal is the where tendons attach into bones

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10
Q

What is osteoporosis?

A
  • reduced bone mineral density
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11
Q

What is Osteomalacia?

A
  • mineralisation of the bone is low

- less severe form of osteoporosis

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12
Q

What is Osteomyelitis?

A
  • infection of a bone
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13
Q

What is a osteosarcoma?

A
  • malignant bone tumour
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14
Q

Joint inflammation can occur in one or more joints. What does the following refer to?

MonoARTHRITIS
OligoARTHRITIS
PolyARTHRITIS

A
  • MonoARTHRITIS = arthritis affecting 1 joint
  • OligoARTHRITIS = arthritis affecting 4 or fewer joints (2-4)
  • PolyARTHRITIS = arthritis affecting 5 or more joints (>=5)
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15
Q

What does inflammation relate to in rheumatoid arthritis?

A
  • inflammation of a joint with an immune response

- immune system attacks there own joints

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16
Q

How long would morning stiffness last for in inflammatory and non-inflammatory conditions?

A
  • inflammatory = >1 hour (RA)

- non-inflammatory conditions = <30 minutes (osteoarthritis)

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17
Q

Does exercise improve or accentuate joint pain in inflammatory and non-inflammatory conditions?

A
  • inflammatory = improves (reduces joint pain)

- non-inflammatory conditions = worsens

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18
Q

Does rest improve or accentuate joint pain in inflammatory and non-inflammatory conditions?

A
  • inflammatory = accentuates (makes worse)

- non-inflammatory conditions = reduces pain

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19
Q

Is joint pain worse in the morning or evening in inflammatory and non-inflammatory conditions?

A
  • inflammatory = worse in the morning

- non-inflammatory conditions = worse in the evening

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20
Q

In patients with inflammatory and non-inflammatory joint pain, do they suffer with fatigue?

A
  • inflammatory = profound

- non-inflammatory conditions = minimal

21
Q

Would steroid be useful in inflammatory and non-inflammatory joint pain?

A
  • inflammatory = dramatic effect

- non-inflammatory conditions = minimal effect

22
Q

In an inflammatory joint disorder, which involved the immune system attacking your own joints, is the swelling acute or chronic?

A
  • generally chronic

- >6 weeks

23
Q

In an inflammatory joint disorder, which involves the immune system attacking your own joints, is it generally just one joint that is affected?

1 - MonoARTHRITIS
2 - OligoARTHRITIS
3 - PolyARTHRITIS

A
  • no

- >3 joints so OligoARTHRITIS or PolyARTHRITIS

24
Q

In an inflammatory joint disorder, which involved the immune system attacking your own joints, what are 2 inflammatory markers that can be measured clinically?

1 - CRP and creatine kinase
2 - creatine kinase and erythrocyte sedimentation rate
3 - CRP and erythrocyte sedimentation rate
4 - CRP and IL-6

A

3 - CRP and erythrocyte sedimentation rate

25
Q

What are the 2 key joints in the hands that are commonly affected in RA?

1 - DIP and PIP
2 - DIP and MCP
3 - MCP and PIP
4 - MCP and DIP

MCP = metacarpophalangeal joint
PIP = proximal interphalangeal joint
DIP = distal interphalangeal joint
A

3 - MCP and PIP

- wrist can also be affected

26
Q

The 2 key joints in the hands that are commonly affected in RA are the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. What joints in the feet can be affected?

1 - digits I-V MTP joints
2 - digits II-V MTP joints
3 - PIP and all MTP joints
4 - DIP and PIP joints

MTP = metatarsophalangeal joint
PIP = proximal interphalangeal joint
DIP = distal interphalangeal joint
A

2 - digits II-V MTP joints

27
Q

RA can be defined as a symmetric polyarthritis, particularly of the MCP, MTP, and/or PIP joints. What do the following parts of this definition relate to?

  • symmetric
  • polyarthritis
A
  • symmetric = occurs on both sides of the body

- polyarthritis = >5 joints affected

28
Q

What are the 2 RA specific antibody markers used in RA?

A
  • rheumatoid factor (RF)

- anti-citrullinated peptide antibodies (ACPA) called anti-CCP

29
Q

Peptides and proteins can undergo citrullination. During inflammation arginine is enzymatically converted into citrulline. If the citrulline forms abnormal shapes like rings, this can present like an antigen and antibodies will target this antigens as a foreign antigen (CD4 and CD8 cells). These can then be measured in the blood as what?

A
  • anti-citrullinated peptide antibodies (ACPA)

- diagnostic marker is referred to as anti-CCP

30
Q

The 2 RA specific antibody markers used to help diagnose are rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPA) (anti-CCP). Do all patients posses these antibodies?

A
  • no, this is can be called sero-negaitve

- could have just RF or ACPA, both or neither

31
Q

What does Sero-positive and Sero-Negative Arthritis mean?

A
  • Sero-positive = patient has symptoms with elevated levels of antibody markers RF and or ACPA
  • Sero-Negative Arthritis = patient has symptoms but no elevated antibodies for RF or ACPA

ACPA is the same as anti-CCP

32
Q

Sero-positive and Sero-Negative Arthritis relate to the presence of absence of RF and/or ACPA (see below). Do patients have the same disease prognosis?

  • Sero-positive = patient has symptoms with elevated levels of antibody markers RF and or ACPA
  • Sero-Negative Arthritis = patient has symptoms but no elevated antibodies for RF or ACPA
A
  • no

- sero-positive patients have worse prognosis

33
Q

30-year-old female, who presents with a three month history of painful, swollen metacarpophalangeal (MCP) joints and wrists. The pain is worse in the mornings and early morning stiffness (EMS) lasts 3 hours. Heat and movement help the pain but when she stops moving her hands the pain returns. Does this patient have Non-inflammatory or Inflammatory joint pain?

A
  • inflammatory joint pain

- long pain in the morning, symptoms improve with exercise but worsen with rest

34
Q

50-year-old ex-rugby player presents with 3 years of painful swollen right knee and painful left hip. He works as builder and by the end of the day the pain is worse. Rest and elevation of the knee helps the pain. EMS lasts 30 minutes. Does this patient have Non-inflammatory or Inflammatory joint pain?

A
  • Non-inflammatory

- improves with rest, morning stiffness is short and pain is worse at the end of the day

35
Q

When we consider joint pain, we need to think is it articular or periarticular. What is periarticular and give a few examples?

A
  • periarticular = outside of the joint cavity

- soft tissue, tendons, bursae, ligaments etc..

36
Q

When we consider joint pain, we need to think is it articular or periarticular. What is articular pain?

A
  • articular = pain from inside the joint cavity

- articular cartilage for example

37
Q

You are asked to review a patient presenting with thenar eminence atrophy. The patient has numbness in the lateral 4 fingers (half of the ring finger). Which nerve do you think is affected?

1 - Ulnar nerve
2 - Radial nerve
3 - Median nerve

A

3 - median nerve

38
Q

RA commonly affects the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the hands, and can affect the wrist. Therefore, what common nerve pathology that involves the trapping of a nerve is common in RA?

1 - cubital syndrome
2 - radial claw
3 - ulnar claw
4 - carpal tunnel syndrome

A

4 - carpal tunnel syndrome

39
Q

Which epicondyle of the humerus is affected in tennis elbow?

1 - Medial
2 - Lateral

A

2 - Lateral

40
Q

What does epicondylitis mean?

A
  • inflammation of epicondyles

- generally where muscles originate and is due to over use

41
Q

What is a connective tissue disease?

1 - damage to connective tissue caused by an infection
2 - damage to connective tissue caused by an vaccine
3 - damage to connective tissue caused by an auto-immune disease
4 - damage to connective tissue caused by an trauma

A

3 - damage to connective tissue caused by an auto-immune disease
- collagen and elastin are the 2 main proteins that are affected and what make up all connective tissue in different proportions

42
Q

The most common connective tissue disease is Systemic Lupus Erythematosus (SLE). What is SLE?

1 - acute autoimmune disease affecting a specific organ
2 - chronic autoimmune disease affecting a specific organ
3 - chronic autoimmune disease affecting non-specific tissue
4 - chronic autoimmune disease affecting a muscles

A

3 - chronic autoimmune disease affecting non-specific tissue

43
Q

Which word would you use to describe muscle inflammation?

1 - Myopathy
2 - Myositis
3 - Myalgia

A

2 - Myositis

44
Q

What is a key marker of muscle inflammation?

A
  • creatine kinase (CK)
45
Q

What % do musculoskeletal disorders account for in terms of death and disability in the UK?

1 - 5%
2 - 10%
3 - 15.6%
4 - 20%

A

3 - 15.6%

- lower back pain accounts for >50%

46
Q

How much do you estimate the NHS in the UK spends in a year on treating musculoskeletal conditions?

1 - 50 million
2 - 1 billion
3 - 10 billion

A

3 - 10 billion

47
Q

What accounts for 20% of all GP appointments?

1 - eye problems
2 - heart problems
3 - hearing problems
4 - musculoskeletal disorders

A

4 - musculoskeletal disorders

48
Q

Rheumatoid factor is an autoantibody, which is an antibody that recognised part of our normal cells as foreign. RF are autoantibodies that target what region of IgG?

1 - Fc region
2 - Fab region
3 - hinge
4 - heavy chain

A

1 - Fc region

Year 2 MIS (48 decks)

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