MSK

Question 1

definition seronegative arthitides

Answer 1

inflammatory rheum disease, inflammation of axial and peripheral joitns and enthesitis (inflammtion where tnedon meets bone)

Question 2

extra articular features seronegagive

Answer 2

anterior uveiitis and bowel lesions

Question 3

3 conditions under umbrella sero -ve

Answer 3

ank spond, rieter’s, enteropathic, psoriatic, behcet’s, Junior idiopathic

Question 4

RF sero -ve

Answer 4

fam hx, HLA b27

Question 5

3 symptoms sero -ve

Answer 5

inflammatoy back pain, stiff in morning, sacroiliitis, enthesitis, sausage fingers, urethritis,

Question 6

Inv for sero -ve

Answer 6

ESR and CRP, urte, RF, antinulcear, serology testing, xray sacroiliac joints (inflammation), bamboo spine, sqauring of vertebrae

Question 7

management sero -ve

Answer 7

physio, NSAIDS< DMARDS, joint replacement

Question 8

pathophys of Pagets

Answer 8

inc bone turnover, inc activity of osteoclasts, new bone weak and brittle

OLD PEOPLE

Question 9

symptom pagets

Answer 9

bone pain, at night, bone deformity (bowing tibia, kyphosis, bossing skull), deafness and tinnitus

Question 10

inv for pagets

Answer 10

raised ALP, normal ca and po4

xray - skull - cotton wool pattern - multifocal sclerotic patches

Question 11

management pagets

Answer 11

orthotics, sticks, walkers
nsaids
BISPHOSPHONATES

Question 12

osteomalacia

Answer 12

(is rickets when childern)

inadeqaute mineralisation VIT D!!!!, results in loss of skeletal mass

Question 13

symptoms osteomalaci

Answer 13

pain, prox muscle weakness, skeletal deformity - vertebrae a skull, change in gait, fractures

Question 14

bloods osteomalacia

Answer 14

high alk phos, FBC

xray - looser’s zones

Question 15

management osteomalacia

Answer 15

vit D supps, dietary get ou in sun

Question 16

primar y benign bone tumour

Answer 16

osteoid, cartilage – chondroma, firbous – fibroma, bone marrow – eosinophillic granuloma, vascular – haemoangioma

Question 17

secondary malignant bone mets

Answer 17

osteosarcoma, chondrosarcoma, fibrosarcoma, ewings, angiosarcoma

Question 18

symptoms bone tumour

Answer 18

patho fract, growth and malignany

Question 19

SLE definition

Answer 19

chronic AI condition, multi system, antinuclear antibodies occur

Question 20

RF SLE

Answer 20

DR2 DR3, UV light, methyldopa

Question 21

sx SLE

Answer 21

relapses and remits (remember weird finnish woman)
maliaise, fever, fatigue, splenomegaly, lymphadenopathy, weight loss

joint muslce pains, EMstifness,

butterfly rash, sparing nasolabial folds,

discoid lupus - sun exposed areas, erythematous, well demarcated, scaling

headache,

raynauds

dry eyes and mouth

fucking everything

Question 22

Inv SLE

Answer 22

anaemia, leukopenia, thrombocytopenia, auto ab - ANA, anti dsDNA

Question 23

management SLE

Answer 23

avoid sun, (think weird white finnish woman) hydroxychloroquine, cyclophosphamide

Question 24

scleroderma def

Answer 24

widespread small vessel damage, fibrosis in skin and systemic organs

Question 25

types of scleroderma (3)

Answer 25

pre-scleroderma (raynauds +antinulcear ab) diffuse cutaneous (worst - raynauds + lung, heart, GI, renal disease) limited cutaneous (middle best - CREST - calcinosis, raynauds, esopageal dys, scelrodactyly, telangiectasia)

Question 26

Lung issues scleroderma

Answer 26

pul fibrosis

Question 27

heart issues scleroderma

Answer 27

pericarditis, pericardial effusion, myocardial fibrosis, heart failure

Question 28

GI issues scleroderma

Answer 28

dry mouth, dysmotilithy, constipation, reflux, watermelon stomach,

Question 29

blood tests sclero

Answer 29

antinuclear antobodies anti centromer, anti scl 70 (anti topoisomerase)

Question 30

other inv sclero (think about issues that arise)

Answer 30

ecg, echo, endoscopy, barium studies, U+E , radiography, skin biopsy§

Question 31

management sclero | skin, raynauds, lung, GI, renal, myositis

Answer 31

skin - moisturisers, lasers, raynauds - keep warm,long acting CCB (nifedipine) add phosphodiesterase i (sildenafil) lung - pul hypertension - bosentan, sildenafil GI - PPI, promotility, pancreatic supps, PEG feed, renal - acei

Question 32

most common causative agents septic arthritis

Answer 32

staph, haemophilus, coliforms

Question 33

in septic arthritis of hip, how is joint held?

Answer 33

flexed, slightly externally rotated

Question 34

sepsis in prosthetic joint

Answer 34

remove prosthesis before full eradication is possible

Question 35

clinical features temporal arteritis

Answer 35

headache, temporal or occipital, severe, worse at night

Question 36

visual manifestations of temporal arterial disease

Answer 36

blurred vision, amaurosis fugax