Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Core Conditions AJL (minus renal and respiratory) > Locomotor > Flashcards

Locomotor Flashcards

1
Q

How common is osteoarthritis?

A

Prevalence increases with age

Causes joint pain in 8.5 million in UK.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who does osteoarthritis affect?

A

M>F

Increasing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of osteoarthritis?

A

In synovial joints, a variety micro traumas and abnormal biomechanics can trigger repair processes
When the joint does not fully repair symptomatic OA occurs
Genetic factors are important in determining outcome of repair process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for osteoarthritis?

A 
Genetics
Ageing 
Gender
Obesity 
High/Low bone density
Joint injury
Occupational and recreational stresses on joints
Reduced muscle strength
Joint laxity
Joint misalignment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the symptoms of Osteoarthritis?

A

Joint pain exacerbated by exercise and relieved by rest
Rest and night pain
Knee pain, bilateral and felt in and around knee
Hip pain in OA is felt in the groin and anterior/lateral thigh
Hip OA pain can also be referred to knee/testicle
MORNING/POST REST joint stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the signs of osteoarthritis on examination?

A 
Reduced ROM
Pain on movement of the joint or at the extremes of joint movement
Joint swelling/synovitis
Periarticular tenderness
Crepitus
Absence of systemic features
Bone swelling and deformities (heberdens and bouchards)
Joint instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the possible differential diagnoses of osteoarthritis?

A 
Inflammatory arthritis
Fibromyalgia
Septic arthritis
Fracture
Major ligament injury
Bursitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigations are necessary to diagnose osteoarthritis?

A

Plain X-Rays
MRI
Blood tests return normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the treatments than osteoarthritis?

A 
Muscle strengthening
Weight loss
AIDS and devices
Painkillers 
Corticosteroid intra-articular injections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is gout?

A

A disorder of purine metabolism, characterised by a raised uric acid level in the blood and the deposition of urate crystals in joints and other tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is gouty arthritis?

A

Arthritis due to urate crystals in the joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does gout occur?

A

3 phases:

  • long period of hyperuricaemia before gout manifests
  • a period during which acute attacks of gouty arthritis are followed by variable intervals with no symptoms
  • final period of tophaceous gout where people have nodules affecting joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How common is gout?

A

Prevalence of 1.4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who does gout affect?

A

More common in men

More common in older people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes Gout?

A

Uric acid exists as sodium urate in extracellular fluid

Gout attacks extremities and temperature in hands and feet cold enough to precipitate urate from plasma leading to deposits on the joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the risk factors for gout?

A 
Gender (male)
Meat
Seafood
Alcohol
Diuretics
Obesity
Hypertension
Cardiovascular disease
Diabetes mellitus
Chronic renal failure
Severe psoriasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the symptoms of gout?

A

Development of acute pain in a joint - swollen, tender, erythematous and reaches crescendo over 6-12 hour period = highly suggestive of crystal arthropathy

Inflammation reaches peak within 24 hours and accompanied by fever and malaise

50% of all attacks and 70% of first attacks affect 1st MTP joint of big toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the signs of gout on examination?

A

No single examination

Arthritis = swelling redness warmth and pain on passive movement, 1st MTP joint most often affected

Tophi = firm, white, translucent nodule
- usually takes 10 years after first attack of acute gout for tophi to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the differential diagnoses of gout?

A

Acute attacks - sepsis and other forms of crystal- related synovitis
- septic arthritis - must be considered if systemically unwell

Chronic tophaceous

20
Q

What investigations are necessary to diagnose gout?

A

Joint fluid and microscopy

Serum uric acid

Joint X-ray

21
Q

What are the treatments of gout?

A

Acute:
Drugs:
- NSAIDs and PPI

Prevent recurrent attacks of gout:

  • allopurinol - use for recurrent attacks
  • febuxostat - management of chronic hyperuricaemia

Lifestyle:

  • weight
  • reduce alcohol intake
  • stop smoking
  • regular exercise
22
Q

How common is septic arthritis?

A

2.8 cases per 100,000 person- years

23
Q

What causes septic arthritis?

A 
Staph aureus
Streptococci
Neisseria goon occurs
Gram -ve bacilli
- bacteria can get into joint via blood stream - from an infection in another part of the body and travel to a bone
24
Q

What are the risk factors for septic arthritis?

A 
Pre-existing joint disease - RA
Diabetes mellitus
Immunosuppression
Chronic renal failure
Prosthetic joints
Increasing age
25
Q

What are the symptoms of septic arthritis?

A

Classic picture= single swollen joint with pain on active or passive movement.
Knee is involved in 50% of cases.

Fevers and rigors in the majority of cases

26
Q

What are the signs of septic arthritis on examination?

A

Joint usually swollen, warm, tender, and exquisitely painful on movement

An effusion may be obvious

27
Q

What are the differential diagnosis of septic arthritis?

A 
Rheumatoid arthritis
Vasculitis
Crystal arthropathies
- gout
- pseudo gout
28
Q

What investigations are necessary to diagnose septic arthritis?

A

Urgent joint aspiration for synovial fluid microscopy and culture

FBC- show elevated WCC, ESR CRP inflammatory markers

Blood cultures

Imaging - CT and MRI show Periarticular abscesses

29
Q

What are the treatments for septic arthritis?

A

Antibiotics started IV initially for 2-3 weeks before switching to oral for a further 2-4 weeks

Flucloxacillin

Cefotaxine for gram -ve organisms for gonococcal arthritis

Repeated percutaneous aspiration

Splint limb in position of function

30
Q

What are the red flags of back pain?

A

Cauda equina syndrome:

  • saddle (perianal) anaesthesia or paraesthesia
  • recent onset of bladder dysfunction
  • recent onset of faecal incontinence
  • severe/progressive neurological deficit in lower extremities

Spinal fracture

  • sudden onset of severe central pain in the spine, relieved by lying down
  • major trauma
  • minor trauma (strenuous lifting with osteoporosis)
  • structural deformity of the spine

High risk of permanent damage to the compressed nerve:

  • significant muscle weakness or wasting
  • loss of tendon reflexes
  • presence of positive babinski reflex
31
Q

How common is a prolapsed disc?

A

Bouts of back pain v common

Less than 1 in 20 are due to prolapsed disc

32
Q

Who does a prolapsed disc affect?

A

Most common in

33
Q

What causes a prolapsed disc?

A

Cause not clear

Some people may have a weaker outer part of affected disc

34
Q

What are the risk factors of a prolapsed disc?

A 
Occupation (lots of lifting or sitting)
Weight-bearing sports
Smoking
Obesity
Increasing age
35
Q

What are the symptoms of a prolapsed disc?

A

Sciatica

  • unilateral leg pain - in buttocks and lower limb
  • numbness, paraesthesia, weakness or loss of tendon reflexes
  • backache/pain

Thoracic disc herniation
- symptoms similar to lumbar disc lesions

Cord compression:

  • neurosurgical emergency
  • thoracic spine can lead to paraplegia
  • may be clonus/babinski positive
36
Q

What are the signs of a prolapsed disc on examination?

A

Sciatic scoliosis - pt may stand with leg to one side
Range of back movements severely limited in all planes
Tenderness in midline of lower back

Neuro exam- at corresponding level of prolapse may find muscle weakness, diminished reflexes, sensory loss
L5 impairment - weakness of big toe extension, knee flexion,
S1 impairment - weak plantarflexion, weak eversion of foot,

37
Q

What are the differential diagnoses of a prolapsed disc?

A 
Abdominal pain in elderly
AAA
RA
Mechanical back pain
Cauda equina syndrome
Pelvic fractures
38
Q

What investigations are necessary to diagnose a prolapsed disc?

A

MRI v sensitive at showing disc herniations

CT myelography

Plan X-rays

39
Q

What are the possible treatments of a prolapsed disc?

A

Analgesia- paracetamol, NSAIDs, opioids

  • benzodiazepines if muscle spasms
  • gabapentin

Lifestyle- keep active, heat and massage

Physiotherapy

Surgery

40
Q

What is Rheumatoid Arthritis?

A

Common chronic inflammatory autoimmune disease

41
Q

How common is rheumatoid arthritis?

A

Prevalence of 1% of UK population

42
Q

What are the risk factors for rheumatoid arthritis?

A

Genetic susceptibility
Smoking, alcohol
Diabetes

43
Q

What are the symptoms of rheumatoid arthritis?

A

Arthritis usually starts as insidious symmetrical polyarthritis, often with nonspecific systemic symptoms

RA typically causes symmetrical joint synovitis of small joints of hands and feet
Pain, swelling and heat in affected joints
Pain WORSE AT REST/DURING INACTIVITY
Stiffness in the morning

44
Q

What are the signs of rheumatoid arthritis on examination?

A 
Symmetrical, distal small joint arthritis involving PIP, MCP, wrist, MTP, ankle knee and cervical spine joints
Hand deformities:
- ulnar deviation
- swan neck and boutonnières deformity
- Z deformity of the thumb

rheumatoid nodule
Muscle wasting and tendon rupture

45
Q

What are the treatments for rheumatoid arthritis?

A

Pain relief - paracetamol ➡️ NSAIDs + PPI

Disease modifying anti rheumatic drugs (DMARDs) - methotrexate and sulfasazaline

46
Q

What is osteoarthritis?

A

A disorder of synovial joints, characterised by focal areas of damage to the articulate cartilage, remodelling of underlying bone and the formation of osteophytes and mild synovitis.

Knees, hips and the small joints of the hands are the most commonly affected joints

Core Conditions AJL (minus renal and respiratory) (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions