Brainscape's Knowledge GenomeTM

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


See full index

Y3 Core Conditions > Locomotor > Flashcards

Locomotor Flashcards

1
Q

Osteoarthritis

A

Degenerative condition in which cartilage of the joint wears away. AKA Degenerative Arthritis

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

How common is osteoarthritis

A

Females 3x more than males

>50yo

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

Causes of Primary Osteoarthritis

A

Aging. With aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates.

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

Causes of Secondary Osteoarthritis

A

Rheumatoid arthritis, gout, septic arthritis, Paget’s disease of bone, Avascular necrosis, metabolic disease e.g. acromegaly, systemic disease

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

Process of Osteoarthritis

A

Cartilage wears and degenerates.
Cartilage ulceration exposes underlying bone to stress, producing microfractures and cysts.
Bone attemts repair but produces sclerotic bone and overgrowths at joint margins calles osteophytes
Macrophages releases VEGF leading to vascularisation of the joint

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

Risk factors for Osteoarthritis

A

Genetics, increased age, female, obesity, joint injury, occupational, reduced muscle strength, joint laxity, joint misalignment, osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of Osteoarthritis

A

Joint pain, RELIEVED BY REST, WORST ON EXERCISE,joint stiffness in the morning lasting no longer than 30mins, joint instability, localised disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of Osteoarthritis

A 
Joint tenderness
Polyarticular (affects more than 5 joints)
Crepitus
Limitation decreases range of movement
Heberdens nodes at DIP
Bouchard's notes at PIP
Synovitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differentials for Osteoarthritis

A 
Rheumatoid arthritis (morning stiffness lasting < 30 mins, symmetrical joint pain)
Gout
Ankylosing spondylitis
Septic Arthritis
Bursitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Investigations for Osteoarthritis

A

Rheumatoid Factor and anti-nuclear antibody negative
CRP normal
ESR normal

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

X-ray finding in Osteoarthritis

A 
LOSS
Loss of Joint Space
Osteophytes
Subchondral Cysts
Sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drugs for Osteoarthritis Pain

A

Acetaminophen
NSAIDS e.g ibuprofen, diclofenac
Duloxetine (antidepressant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for Osteoarthritis

A 
Exercise to increase muscle mass and strength around knee
Weight loss
Cortisone injections
Lubrication injections
Realigning bones
Arthroplasty (joint replacement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prognosis for Osteoarthritis

A

Most people with OA do not become severely disabled but knee OA holds the worst prognosis and hand the best

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

Rheumatoid Arthritis

A

Autoimmune disease causing symmetrical polyarthritis and synovial inflammation. Type 3 hypersensitivity reaction

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

How common is RA

A

Females 2x more than Males

Onset 50-60yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of RA

A

Genetics: familial pattern with high concordance in monozygotic twins
Gender
Immunology: synovial Inflammation due to T cell Activation

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

Pathology of RA

A 
Synovium shows:
Increased angiogenesis
Cellular hyperplasia
Influx of inflammatory cells
Cytokines
High level of metalloproteinase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Symptoms of RA

A

Symmetrical​, Deforming​, Peripheral​, Polyarthritis, Joint pain, WORST AT REST, BETTER WITH EXERCISE, morning stiffness, affect mainly hands and feet then progresses to larger joints, fatigue and weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs of RA on the Hand

A

Ulnar deviation of the finger and dorsal wrist subluxation
Boutonniere or swan neck deformity of fingers
Z deformity of the thumb
Raynauds
Carpal Tunnel syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Investigations for RA

A

ESR, CRP and platelets raised
RF and anti-CCP antibodies positive
Nomochromic normocytic anaemia
X-ray: bony erosion, subluxation, carpal instability, joint involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Differentials for RA

A 
Osteoarthritis
SLE
Gout
Psoriatic arthritis
Infectious arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment for RA

A 
DMARDs (Disease Modifying Antirheumatic Drugs): Methotrexate (mmunosuppresant), Hydroxychloroquine (anti-malarial), Sulfasalazine (aminosalicylate)
NSAIDS
Glucocorticoids
Exercise, physiotherapy
Arthroplasty surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Complications of RA

A

Septic Arthritis
Amyloidosis
Carpal Tunnel Syndrome

25
Q

Gout

A

Hyperuricaemia and deposition of urate crystals causing inflammatory arthritis
Tophi around the joint destruction
Renal glomerular, tubular and intersitial disease
Uric acid urolithiasis
Most commonly affects metatarsaophalangeal joint big toe, foot, ankle, knee, fingers, wrist and elbow

26
Q

How common is Gout

A

Increases with age

More common in men

27
Q

Causes of Gout

A

Hyperuricaemia caused by underexcretion of urate in 90% of cases and over-production of urate in 10% of cases
Urate is a metabolite of purines and ionised form of uric acid

28
Q

Risk factors for Gout

A 
Age
Male
Consumption of seafood, meat and alcohol especially beer
Haematological cancer and chemotherapy
Diuretic use
Ciclosporin or tacrolimus use
Obesity
Insulin resistance
Hypertension
29
Q

Symptoms and signs of Gout

A 
Rapid-onset severe pain
Joint stiffness
Most common affected joints are feet
Swelling and joint effusion
Tenderness
Tophi
Erythema and warmth
30
Q

Tophi

A

Nodular deposits of uric acid in soft tissues of the body

31
Q

Differentials for Gout

A 
Pseudogout (calcium pyrophosphate deposition disease)
Septic arthritis 
Trauma
Rheumatic Arthritis
Reactive Arthritis
Psoriatic Arthritis
32
Q

Treatment for Acute Gout

A
  1. NSAID
  2. Colchicine
  3. Corticosteroid
33
Q

Treatment for Recurrent Gout

A

2-3 weeks post-acute episode

  1. Xanthine oxidase inhibitor- Allopurinol
  2. Probenecid or sulfinpyrazone
  3. IV Pegloticase
  4. Suppressive therapy
34
Q

Complications for Recurrent Gout

A

Nephrolithiasis

Acute Uric acid Nephropathy

35
Q

Septic Arthritis

A

Infection of 1 or more joints caused by pathogenic inoculation of microbes. Occurs either by direct inoculation or via haematogenous spread

36
Q

Causes of Septic Arthritis

A

Staphylococcus or Streptococcus

37
Q

Risk factors for Septic Arthritis

A 
Underlying joint disease RA or OA
Joint prostheses
IV drug abuse
Alcohol use disorder
Diabetes
Previous intra-articular corticosteroid injection
Cutaneous ulcers
38
Q

Symptoms and signs of Septic Arthritis

A

Hot, swollen, tender, restricted movement of joint and fever

39
Q

Investigations for Septic Arthritis

A 
Synovial fluid gram stain and culture
Synovial fluid WCC
Blood culture
Elevated WCC 
CPR and ESR elevated
40
Q

Differentials for Septic Arthritis

A

Osteoarthritis, Rheumatic Arthritis, Gout, Haemarthrosis, Trauma, Bursitis, Cellulitis

41
Q

Treatment for Septic Arthritis

A

Joint aspiration

IV Abx: flucloxacillin, clindamycin if penicillin alllergic

42
Q

Complication of Septic Arthritis

A

Abx associated allergic reaction
Osteomyelitis
Joint destruction

43
Q

Prolapsed Disc

A

Disc degeneration. A soft cushion of tissue between the bones in the spine pushes out and can press on nerves. Commonly affects lumbar spine

44
Q

Pathophysiology of a Prolapsed Disc

A

Each disc has a Nucleus Pulposus surrounded by Annulus Fibrosus to provide resistance and disc stability. The normal human circadian rhythm allows for fluid shifts in and out of the disc. Degenerative changes follow a loss of hydration of the nucleus pulposus.

45
Q

Risk factors for a Prolapsed Disc

A

Increasing age, occupation i.e. carrying excessive load, smoking, obesity

46
Q

Symptoms and signs of a Prolapsed Disc

A

Lower back pain
numbness or tingling in your shoulders, back, arms, hands, legs or feet
neck pain
problems bending or straightening your back
muscle weakness
pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica)
Unilateral pain

47
Q

Investigations for Prolapsed Disc

A

MRI

CT

48
Q

Differentials for Prolapsed Disc

A

Sprain, Strain, Spinal Tumour, Spinal Infection, Postural back pain

49
Q

Treatment for Prolapsed Disc

A

Rest if severe pain but stay active
Paracetamol and NSAIDs
Spinal Cord Compression

50
Q

Osteoporosis

A

Skeletal disease characterised by low bone density and micro-architectural defects in bone tissue. Results in increased bone fragility and susceptibility to fracture. Common fractures are in the hip, vertebrae and wrist.

51
Q

How common is Osteoporosis

A

Affect 1 in 2 women and 1 in 5 men
> 50 yo
Predominance in whte, post-menopausal women

52
Q

Pathophysiology of Osteoporosis

A

Increases osteoclast activity (more bone resorption)
Decreased osteoblast activity (less bone remodelling). Net increase in bone resorption
Bone remodelling by hormone including PTH, vitamin D, calcitonin and oestrogen

53
Q

Risk factors for Osteoporosis

A

Steroid use (prednisolone)​
Hyperthyroid, hyperparathyroidism, hypercalciuria ​
Alcohol and tobacco use​
Thin (BMI<22)​
Testosterone ↓​
Early menopause​
Renal failure/live failure​
Erosive/inflammatory bone disease (RA/myeloma)​
Dietary calcium ↓ and low Vit D (malabsorption) or Diabetes

54
Q

Symptoms and signs of Osteoporosis

A

Back pain
Kyphosis
Pain and swelling at fracture sites

55
Q

Investigations for Osteoporosis

A

DEXA scan to measure bone density
Xray
Serum Calcium, creatinine, phosphate, 25-hydroxy vitamin D, PTH, TFT

56
Q

DEXA Scan Result

A

T score > -1 : Normal
T score < -1 but >-2.5: Osteopenia
T Score of

57
Q

Differentials for Osteoporosis

A 
RA, gout
Multiple myeloma
Osteomalacia
CKD
Primary Hyperparathyroidism
Metastatic bone malignancy
58
Q

Treatment for Osteoporosis

A

1) Bisphosphonates: Alendronic acid (PO daily), Zolendronate (IV as a single dose yearly)
2) Calcium and Vitamin D supplementation
3) Raloxifene (anti-resorptive drugs)
4) Terparatide (PTH analogue)

59
Q

Complications of Osteoporosis

A

Hip, rib and wrist fractures

Jaw necrosis associated with bisphosphonate treatment

Y3 Core Conditions (13 decks)

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