Lectures I Flashcards
What is the medication given to treat osteoporosis?
Bisphosphonates: Alendronate 70MG weekly, Risedronate weekly, Ibandronate monthly
IV bisphosphonate: zoledronate 5MG yearly
What are the 3 pre-treatment checks for osteoporosis treatment?
- eGFR >35ml/min
- Normal calcium and vitamin D
- Healthy teeth
What is the mechanism of action of bisphosphonates?
Bisphosphonates inhibits the resorption of bone by osteoclasts and
What does PMR stands for?
Polymyalgia Rheumatica
Where are the sites of pain in PMR?
Neck, shoulders, upper arms and hips
When does the pain usually occur in?
Pain usually occurs in the early morning
What is the other condition that patients with PMR might experience? Describe this condition and its possible complications.
Patients with PMR may have temporal arteritis which is an inflammation of blood vessels in the face. TA can cause blindness if not treated promptly
What is the condition in:
A young lady came in presenting with stiffness to her lower spine. Pain is usually worst in the early morning and will be relieved with movement (takes about 30mins).
Ankylosing Spondylitis
Pain that is worst at night (nocturnal pain) that causes the patient to wake up
Usually from malignancy
- Pain with leg raise test. What does it indicate?
2. No pain with leg raise test
- Intervetebral prolapse disc. Usually any conditions affecting the nerve compression.
- Fractures of the lower back
What is the term for ‘limping’?
Antalgic gait
Patient present with bladder, bowel or sexual disturbances. What should you think of?
Think of spinal nerve compression or ankylosing spondylitis
Where is the region of back pain that will be classed under “low back pain”?
Low back pain is localised below the costal margin and above the inferior gluteal folds.
What is considered acute back pain?
What is considered chronic back pain?
Acute back pain is any pain lasting <3months/12 weeks
Chronic back pain is pain lasting >3months/12 weeks
What is the indication of exercise-related leg weakness or numbness?
Spinal stenosis.
Is cervical, thoracic or lumbar back pain a red flag for sinister causes of back pain?
Thoracic back pain is a red flag
What is sciatica?
Sciatica is a radicular pain that travels down the sciatic nerve from the lower spine to the lower back, gluteal muscles, back of the upper thigh, calf and foot.
Which is specific for Rheumatoid Arthritis - Anti-CCP antibodies or Rheumatoid Factors?
Anti-CCP antibodies
Which is not a risk factor for osteoporosis?
- Hyperthyroidism
- Rheumatoid Arthritis
- Obesity
- Patients on Prednisolone
- Smoking
Obesity
A positive Thomas’s test will indicate?
Hip flexion contracture and psoas syndrome.
The iliopsoas could be shortened.
How often is Methotrexate given? What is usually the dose?
Weekly. 2.5MG
Which of the following is not a complication/side effect of steroid use?
- Hypoglycaemia
- Hypertension
- Peptic Ulcer
- Cataracts
- Diabetes
Hypoglycaemia
Which is not a risk factor for osteoarthritis?
- Having a history of Gout
- Obesity
- Female
- Smoking
- Previous joint injury or disease
Smoking
Is Methotrexate safe for pregnant women?
No
