MSK conditions Flashcards

Question

first line treatments for osteoporosis

Answer 1

Bisphosphonates(alendronate, risedronate) * Calcium and Vitamin D ## Footnote alendronate, risedronate due to their broad spectrum of anti-fracture efficacy

Answer 2

Bisphosphonates are adsorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone turnover. they increase bone density ## Footnote inhibits osteoclast activity

Answer 3

Denosumab , reduces osteoclast formation there are other second lines but this is the most common ( I think)

Answer 4

Atypical femoral fractures Patients should be advised to report any thigh, hip, or groin pain during treatment with a bisphosphonate. Osteonecrosis of the jaw During bisphosphonate treatment patients should maintain good oral hygiene, receive routine dental check-ups, and report any oral symptoms. Osteonecrosis of the external auditory canal Patients should be advised to report any ear pain, discharge from ear or an ear infection during treatment with a bisphosphonate. May interact with calcium products so do not take them together

Answer 5

its use is generally restricted to younger postmenopausal women with menopausal symptoms who are at high risk of fractures. ## Footnote tibolone may be recommended as well in this case

Answer 6

Weight bearing exercise * Calcium in the diet * Vitamin D – sun exposure * Stop smoking * Only drink alcohol within recommended limits ## Footnote examples of weight beaering exercises; walking, dancing, stair climbing, and racket sports.

Answer 7

Bisphosphonates should be continued for 3-5 years, then reviewed

Answer 8

damage to the body's soft tissues, like damage to the body's soft tissues, like muscles, tendons, ligaments, fascia and synovial capsules leading to inflammation and pain ## Footnote more prevalent in sporty individuals. mostly due to physical activity

Answer 9

A sprain is a stretch or tear in a ligament, which are the tough bands of tissues connecting your bones together (therefore occurs at a joint). here the joints are forced into an abnormal position while A strain is a stretch or tear in a muscle or tendon. aka pulled muscle or tendons. ## Footnote A tendon is the flexible tissue which connects muscles to bone.

Answer 10

*exercising – for example, playing sport *have strained a muscle in the past *fall *move or twist suddenly – for example, sprinting or catching a falling child *have a heavy blow to your muscle – for example when playing contact sports such as rugby *are overweight because this puts more stress on your muscles *do a repetitive movement that puts stress on your muscle – for example, painting a ceiling all day *don’t have enough strength in your muscles for the activity you’re doing not warming up properly before physical activity

Answer 11

Swelling Tender, red and warm to touch Weakness or instability Muscle spasm or cramping Inability to fully straighten your arm, leg, etc. Bruising (may take 24 hours before bruise fully appears) If you hear a pop or snap sound when you hurt yourself, you may have torn a ligament or broken a bone. ## Footnote note sprains are more likley to occur if history of previous sprains, as ligaments may be weaker, even after they have healed

Answer 12

Stiffness or decreased movement Pain Painful “pop” that can be heard or felt Swelling or bruising Sometimes ‘instability in the joint’ can be felt “feels wobbly

Answer 13

the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL)

Answer 14

Pain, often sudden and severe **A loud pop or snap during the injury** Swelling within the first 24 hours after the injury **A feeling of looseness in the joint **Being unable to straighten the knee**** Inability to put weight on the joint without pain, or any weight at all

Answer 15

Marked swelling, bruising and pain occurring straight after injury. **Numbness in the injured area**. High impact injury – likely fracture, inability to full weight-bear Marked reduction in normal range of motion if there is Referred pain as it suggests nerve root compression; progressive pain suggests possible degenerative disease Bones are softer in children, more likely to get ‘greenstick’ fractures Elderly – establish risk factors/likelihood of underlying conditions (OA, OP) ## Footnote Referred pain is pain that's felt in a different part of the body than where the pain originates A greenstick fracture is an incomplete fracture, meaning the bone cracks on one side but doesn't break completely through, resembling a bent, partially broken green branch

Answer 16

PRICE initially, then proceed to MICE after 3 days

Answer 17

Protect Rest (injured area should be rested for 48hours) Ice(10 - 20 mins at a time, 4-8 times per day) Compression Elevation( 6-8 inches above heart)

Answer 18

Movement (Gentle exercise to limit stiffness and promote healing) Ice (10 - 20 mins at a time, 4-8 times per day) Compression Elevation(6-8 inches above heart 3 days)

Answer 19

refer to orthopaedic specialist, to be put back in place. this can take up to 6 weeks

Answer 20

Analgesia – Paracetamol and Topical NSAIDs (Oral NSAIDs if still in pain) if the pain is persistent, them refer to a doctor as it could be a possible rupture

Answer 21

pain directly under the kneecap swelling and bruising in front of the knee a defect, or soft spot around the knee area difficulty walking or doing sports activities

Answer 22

Tendinosis – small tears in the tendons Tendonitis – inflammation of the tendons Tenosynovitis – inflammation of the tendon sheaths ## Footnote these are all usually due to overuse of the tendon

Answer 23

pain in the front of the kneecap which is due to overuse, injury, excess weight..etc being put on the knee

Answer 24

thickening or folding of the ligaments

Answer 25

a painful inflammation of the fluid-filled sacs that cushion joints. It's usually caused by repetitive motions or injuries. usually occurs in the shoulder, elbow, hip, knee, heel, and base of the big toe.