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Phase 2a Yellow Conditions > MSK > Flashcards

MSK Flashcards

1
Q

What are the common primary bone tumours?

A
  • chondrosarcoma
  • osteosarcoma
  • Ewing sarcoma
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2
Q

Risk factors of primary bone tumours

A
  • previous radiotherapy
  • previous cancer
  • Paget’s disease
  • benign bone lesions
  • male>female
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3
Q

Presentation of primary bone tumours

A
  • common sites → long bones
  • bone pain
  • atypical bony or soft tissue swelling/masses
  • pathological fractures
  • easy brusiing
  • mobility issues → unexplained limp, joint stiffness, reduced ROM
  • inflammation and tenderness over bone
  • systemic symptoms
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4
Q

What is bone pain like in primary bone tumours?

A
  • worse at night
  • constant or intermittent
  • resistant to analgesia
  • may increase in intensity
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5
Q

Investigations for primary bone tumours

A
  1. xray
    GOLD STANDARD = biopsy

bloods

  • FBC
  • ESR
  • ALP
  • lactate dehydrogenase
  • Ca2+
  • U&E

CT chest/abdomen/pelvis

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6
Q

Management of primary bone tumours

A
  • chemo
  • radiotherapy
  • surgery → limb sparing/amputation
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7
Q

What is multiple myeloma?

A

neoplastic proliferation of bone marrow plasma cells

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8
Q

What are common sites of secondary bone tumours?

A

LEAD KETTLE PBKTL

  • prostate
  • breast
  • kidneys
  • thyroid
  • lungs
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9
Q

Investigations for secondary bone tumour

A

bloods

  • FBC
  • U&E
  • ALP
  • PSA

imaging

  • xray → lytic lesions
  • CT scans → metastases
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10
Q

Management of secondary bone tumours

A
  • pain management
  • bisphosphonates
  • radiotherapy
  • chemo
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11
Q

What is fibromyalgia?

A
  • chronic pain syndrome
  • widespread over body → 11 out of 18 points
  • >3 months
  • non-nociceptive pain
  • no organic cause
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12
Q

Pathophysiology of fibromyalgia

A
  • unknown
  • possibly pain perception or hyper excitability of pain fibres
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13
Q

Presentation of fibromyalgia

A
  • fatigue
  • brain fog
  • pain
  • morning stiffness
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14
Q

Investigations for fibromyalgia

A

exclude all other differential with bloods and imaging

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15
Q

Management of fibromyalgia

A
  • exercise
  • relaxation
  • neuropathic pain relief → TCA, gabapentin, pregabalin
  • opiates
  • CBT
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16
Q

Complications of fibromyalgia

A
  • can really affect QoL
  • anxiety, depression, insomnia
  • opiate addiction
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17
Q

Pathophysiology of Sjogren’s syndrome

A
  • chronic inflammatory autoimmune disorder
  • destruction of epithelial exocrine glands esp lacrimal and salivary glands
18
Q

Signs and symptoms of Sjogren’s

A
  • dry eyes, mouth, vagina (mucous membranes)
  • parotid gland enlargement
  • joint pain
  • Raynauds
  • systemic features
19
Q

What conditions is Sjogren’s associated with?

A
  • RA
  • SLE
  • PBC
  • scleroderma
20
Q

Risk factors of Sjogren’s

A
  • 1st degree relative = 7x increased risk
  • female
  • >40
21
Q

Investigations for Sjogren’s

A

Schirmer tear test
- tears travelling <10mm is significant

Rose bengal staining and slit lamp exam

RFs, ANA, anti-Ro, anti-La

22
Q

Management of Sjogren’s

A
  • artificial tears/saliva, vaginal lubricant
  • humidifier, eye drops, mouth wash
  • NSAIDs, hydroxychloroquine (halts progression)
  • M3 agonist → pilocarpine
23
Q

Complications of Sjogren’s

A
  • conjunctivitis
  • corneal ulcers
  • dental cavities
  • candida infections
  • vaginal candidasis
  • sexual dysfunction
24
Q

What is Raynauds phenomenon

A
  • intermittent spasm in arteries supplying fingers and toes
  • usually precipitated by cold and relieved by heat
  • can also be caused by vibrational tools, smoking, beta blockers
  • associated with SLE, RA, systemic sclerosis, dermatomyositis
25
Q

Treatment for Raynauds phenomenon

A
  • protect hands
  • stop smoking
  • CCBs
26
Q

What is systemic sclerosis?

A
  • multisystem autoimmune disease
  • increased fibroblast activity
  • abnormal growth of connective tissue
  • 2 types → limited and diffuse
27
Q

Signs and symptoms of limited systemic sclerosis

A
  • skin involvement limited to hands, face, feet and forearms
  • characteristic beak like nose and small mouth
  • microstomia
28
Q

Signs and symptoms of diffuse systemic sclerosis

A
  • skin changes develop more rapidly and widespread
  • Raynaud’s phenomenon coincident with skin involvement
  • GI, renal, lung involvement
29
Q

Diagnosis of systemic sclerosis

A
  • ANAs
  • anaemia if renal involvement
  • limited → ACAs
  • diffuse → topoisomerase, anti-scl 70
30
Q

Treatment for systemic sclerosis

A
  • avoid smoking
  • handwarmers
  • GI → PPIs, Abs
  • renal → ACEi
  • pulmonary fibrosis → cyclophosphamide
31
Q

What is polymyositis?

A
  • muscle disorder of unknown aetiology
  • inflammation and necrosis of skeletal muscle fibres
32
Q

What is dermatomyositis?

A

polymyositis and skin involvement

33
Q

Signs and symptoms of polymyositis

A
  • symmetrical progressive muscle weakness and wasting
  • affect proximal muscles of shoulder and pelvic girdle
34
Q

Signs and symptoms of dermatomyositis

A
  • heliotrope discolouration of eyelids
  • scaly erythematous plaques over knuckles
  • arthralgia, dysphagia
  • Raynaud’s
35
Q

Diagnosis of poly/dermato myositis

A

muscle biopsy

bloods → raised

  • serum creatine kinase
  • aminotransferases
  • lactate dehydrogenase
  • aldolase

immunology

  • ANA
  • anti jo1
  • anti mi2
36
Q

Treatment of poly/dermato myositis

A
  • oral prednisolone
  • stronger immunosuppressants
  • symptomatic treatment of skin disease
37
Q

What is antiphospholipid syndrome?

A

antibody mediated acquired thrombophilia

38
Q

Risk factors for antiphospholipid syndrome

A
  • diabetes
  • female
  • HTN
  • obesity
  • SLE
  • oestrogen therapy for menopause
39
Q

Presentation of antiphospholipid syndrome

A
  • thrombosis
  • recurrent miscarriages
  • Livedo reticularis
  • thrombocytopaenia
40
Q

Investigations for anitphospholipid syndrome

A
  • history of thrombosis/pregnancy complications
  • antibody screen
41
Q

Treatment of antiphospholipid syndrome

A
  • long term warfarin
  • LMW heparin and aspirin if pregnant
  • lifestyles changes to avoid CVS issues
42
Q

Complications of antiphospholipid syndrome

A
  • VTE
  • arterial thrombosis
  • pregnancy complications

Phase 2a Yellow Conditions (12 decks)

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