Learning Topics Flashcards
Difference between lamellar and woven bone
Woven laid down by osteoblasts irregularly while lamellar is parallel
Difference between osteoblasts and osteocytes ??
Osteblats are from osteoprogenitor cells while osteoclasts are from mononuclear phagocytic cells
Inheritance of achondroplasia ?
Autosomal dominant
Achondroplasia is a mutation in?
FGFR3 !!
Difference between genetic and acquired dwarfism?
Achondroplasia have normal intelligence and life spans!
Characteristics of OI?
Blue sclera, affected teeth, joints, ears, skin Bone fragility Defective C1 Repeated fractures EXcessive callus formation!
Achondroplasia is a disorder of ?
Growth plates
Why incidence of SLE Increased?
Because of actual increase and improved diagnostic method leading to early diagnosis
Prevalence of SLE?
1:1000 women
Causes of high prevalence ??
Earlier diagnosis = > survival= duration
Increased incidence
Survival has increased
Why different variability in SLE studies ??
Different methods
5 year survival of SLE now and then??
50 years ago 50%
Now 95
Why mortality decreased??
Improved medical care
Changes in definition so now they include milder cases!
How in SLE have high risk of death??
Non Caucasian
Younger age
More severe systemic disease
Life threatening comorbidties in SLE ??
Kidney failure
CNS cerebritis
Cardiovascular disease
Age affected by SLE ??
It can occur ANYTIME!!
but peak incidence in 15-55
Proof of SLE having genetic component ??
Monozygotic twins have 60% chance of concordance
Screening is not recommended in SLE ??
No cost effective or accurate test
Can’t recommend a screening test because??
No benefit of therapy seen in preclinical phase
What causes under excretion of Utica acid?
Polycystic kidney disease
Htn
Renal failure
Which is used to treat acute gout attacks??
Indomethacin and naproxen
Why indomethacin is the NSAIDS Of choice not aspirin ??
Prevents Uric acid excretion
Effect of indomethacin?
Reduce pain and inflammation
Indo and napro are contraindicated in?
Peptic ulcer and liver disease
Why 95%of lumbar disc herniations occur at L4/5 L5/S1 ???
Because the posterior longitudinal ligament thins inferiorly from L1 to S1 !!
Most impingement on nerve roots are assymetric why?
Because most herniations are posterolateral
Ligamentum flavum runs??
Anterior to the lamina within neural canal
What can cause spinal stenosis??
Thinking of ligamentum flavum with age!
Where pain comes from in the lumbosacral region?
Posterior rami and sinuvertebral nerves at each vertebral level
True or false does the nucleus pulposes and annular fiber have pain fibers ??
False
Those who don’t have a pain don’t have a pathology?
No as 20-30% of asymptomatic people have a pathology!
What are LBP causes?
Mechanical(most)
Neurogenic
Referred visceral
Red flag
Mechanical causes of pain?
Spondylosis
Vertebral fracture
Muscle strain and ligamentous injuries(65-70%)
Degenerative disk and joint disease
Congenital anomalies( kyphoscoliosis, transitional vertebra)
Neurogenic LBP?
Spinal stenosis
Herniated disc
Ostyphytic nerve root compression
Red flagged LBP?
Inflammatory spondyloarthropathies
Osteomyelitis discitis abscess
neoplastic(primary/metastatic)
Referred visceral pain?
Abdominal aortic aneurism Gi( Ibd, pancreatitis, diverticulitis) Renal disease( pyelonephritis, renal stones)
Why those with spinal stenosis get relief by spine flexion?
Increase diameter of spinal canal reducing its tension
No pain uphill but pain downhill indicates ?
Spinal stenosis? Because the back is extended
Characteristics of cauda equina syndrome?
Bi lateral legs
Neurosurgical emergency
Difficulty in bladder and bowel function
Causes of cauda equina?
Massive central disc herniation
Spinal epidural abscess
Hematoma
Trauma
