MSK

Question 1

Osteoporosis

Answer 1

2.5 std dev below peak bone mass
atraumatic vertical compression #
visible on XR after 3-40% lost
senile/ high turnover (dec oestrogen)

Question 2

Pagets phases

Answer 2

osteolytic
mixed osteoclastic/blastic
burned out osteosclerotic

Question 3

Morph and bone involvement pagets

Answer 3

inc bone mass disordered and strucurally unsound
mosaic pattern lamellar bone with cement lines
axial skeleton/ prox femur
most asymptomatic

Question 4

\fracture healing

Answer 4

1 week soft callus
2-4w bony callus - max girth 2-3w
callus replaced with lamellar

Question 5

Morphology osteoecrosis

Answer 5

week one no chnage
week two necrosis cells
no loss organic/ inorganic matrix
mainly involves medulla

Question 6

Organisms osteomyelitis

Answer 6

staph aureus most common
IVDU/ post UTI - e. coli, pseudomonas, klebsiella
neonate - GBS, h. inf
sickle cell - salmonella
50% no organism identified

Question 7

Part of bone involved osteomyelitis

Answer 7

neonate - metaphysis and epiphysis
child - metaphysis
adult - epiphysis and subcondral regions

Question 8

Phases OA

Answer 8

early - chondrocytes proliferate, inc water and decrease proteoglycans in cartilage
late - chondrocyte dropout

Question 9

XR osteoarthritis

Answer 9

subchondral cysts
subchondral sclerosis
osteophytes
bony spurs
thinned and fibrillated cartilage

Question 10

heberden node

Answer 10

osetophyte DIPJ women OA

Question 11

ABs in RA

Answer 11

RF - binds to Fc portion IgG
ANA
anti CCP

Question 12

Anticardiolipine ABs

Answer 12

Antiphospholipid syndrome

Question 13

Anti dsDNA ABs

Answer 13

SLE

Question 14

Anti proteinase 3 antibodies

Answer 14

ANCA vasculitis (wegeners)

Question 15

XR RA

Answer 15

joint effusion
juxtaarticular osteopenia
erosion and narrowing joint space
loss articular cartilage

Question 16

Synovial fluid RA

Answer 16

sterile and turbid
decreased viscosity
poor mucin clot formation
inclusion body neutrophils

Question 17

Juvenile idiopathic arthritis

Answer 17

<16y, lasting 6w
ANA +ve
oligoarthritis, large joints
RF negative, no nodules
assoc systemic disease

Question 18

Rheumatoid nodules

Answer 18

in 25% people
in areas subjected to pressure

Question 19

Ank spond

Answer 19

90% HA B27
SI and apophyseal joints
uveitis, aortitis, amyloidosis

Question 20

Reactive arthritis

Answer 20

arthritis + non gonococcal urethritis + conjunctivitis
assox HIV
shigella, salmonella, other GI, chlamydia
assoc HLA B27
6w-6m

Question 21

Enteritis assoc arthritis

Answer 21

yersinia, e. coli, shigella, campylobacter
knees and ankles
sudden onset
lasts 1y

Question 22

Psoriatic arthritis

Answer 22

10% people with psoriasis
DIPJs first, asymmetric
pencil in cup deformity

Question 23

Infective arthritis organism

Answer 23

kids <2y H Inf
older kids and adults staph aureus
gonococcal more likley teen / YA female
sickle cell salmonella

Question 24

Viral causes septic arthritis

Answer 24

alpha virus parvo B19, EBV, hep B and C

Question 25

Gout crystals

Answer 25

negatively birefringent needles

Question 26

Pseudo gout crystals

Answer 26

positively birefringent rhomboids

Question 27

Primary gout

Answer 27

90%
gout main manifestation, cause unknown

Question 28

Secondary gout

Answer 28

10%
increased nucleic acid turnover e.g. leukaemia chemo
dec exretion chronic renal disease
congentital

Question 29

Course gout

Answer 29

asymptomatic
acute - 50% 1st MTPJ
asymptomatic interval
chronic tophaceous

Question 30

Pseudogout

Answer 30

age 50+ affects genders equally
sporadic/ heredtory/ secondary
crystals in cartilage/ menisci/ IV discs and seed into joints
knees > wrists

Question 31

HLA associated rhenatoid

Answer 31

DR4