Joint disease Flashcards
What is the role of osteoblasts?
Build new bone
What is the role of osteoclasts?
Break down old bone
What is osteoporosis caused by?
An imbalance of osteoblast and osteoclast levels.
Reduced osteoblast activity and increased osteoclast activity leading to low bone mass
What is the first sign/symptom of osteoporosis?
Fracture
How is bone mass density determined?
DXA scan
DXA scans usually measure bone density at hip/lower back to get a T score. What score is indicative of osteoporosis?
Score less than or equal to 2.5
What is the pathogenesis of osteoarthritis?
Cartilage gradually roughens and becomes thin. Thickening of underlying bone Formation of osteophytes Thickening and inflammation of synovium Thickening and contraction of ligament
What are some of the non-pharmacological management options for osteoarthritis?
Weight reduction
Physiotherapy
Exercise plan
Heat packs
What are some of the pharmacological management options for osteoarthritis?
Simple analgesics
NSAIDs
Corticosteroids
What is the difference between osteoarthritis and rheumatoid arthritis?
Osteoarthritis usually affects one joint only whereas rheumatoid is more systemic and affects multiple joints
Why is there a likely reduced life expectancy in rheumatoid arthritis?
Due to risk of developing other diseases e.g. CVD
Early morning stiffness is more common in osteoarthritis rather than rheumatoid arthritis. True or false?
False
What is the pathogenesis of rheumatoid arthritis?
Lymphocytes infiltrate the synovial membrane, causing inflammation and thickening
Formation of pannus over cartilage causes erosion into bone
Eventual degeneration of cartilage joint
DMARDs are used in the management of which joint disease?
Rheumatoid arthritis
Why do women have accelerated bone loss around menopause?
Because of the loss of the protective effect of oestrogen - due to decreased levels
How can peak bone mass be optimised?
By having healthy balanced diet and doing weight bearing exercises e.g. aerobics and running early on in life
List 6 risk factors for developing osteoporosis?
Smoking Oestrogen deficiency History of fractures Increasing age Female Excess alcohol consumption History of fracture in first degree relative Corticosteroid use
What are the pre-screening checks before starting biologic DMARDs?
FBC LFT TB HIV/Hep A/B Diabetes MS History of heart disease
Which cDMARD doesn’t require regular blood monitoring?
Hydroxychloroquine
Which cDMARD causes urine discolouration?
Sulfasalazine
Which cDMARD requires folic acid?
Methotrexate as it is a folate antagonist
Which drugs can cause skin rash?
Hydroxychloroquine and sulfasalazine
