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year 2 - clinical pathology > MSK disease > Flashcards

MSK disease Flashcards

1
Q

what is arthritides

A

pain and stiffness of a joint /inflammation of the joint - multiple diseases

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2
Q

what are the acute symptoms of arthritis

A

pain, heat, redness and swelling

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3
Q

what are the two most common types of chronic arthritis

A

OA and RA - pain but no heat or redness

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4
Q

what is the most common type of joint disease

A

osteoarthritis - degenerative joint disease - progressive erosion of articular cartilage

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5
Q

what is the cause and result of osteoarthritis

A

associated with age - no initiating cause

formation of bony spurs and cysts at the margin of joint

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6
Q

which disease would you get bouchards and herberdens nodes

A

primary osteoarthritis - B = proximal nodes

H = distal nodes

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7
Q

which bones are primary OA affected by

A

fingers knees C and L spines

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8
Q

which types of sports are commonly affected by secondary OA

A

knee in basketball players and elbow in baseball players

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9
Q

what is the pathogenesis of secondary OA

A

loss of cartilage, forms spurs for fluid filled cysts in the marrow - subchondral cyst

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10
Q

what happens at the cellular level in secondary OA

A

chrondorcytes produce IL-1 that initiates matrix breakdown

prostaglandin derivatives induce release of lytic enzymes that prevent matrix synthesis

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11
Q

what is rheumatoid arthritis and what does it affect

A

chronic disorder producing non-suppurative proliferative synovitis - results in destruction of articular cartilage and ankylosis of joints
affects skin, muscles, heart lungs

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12
Q

what is ankylosis of joint spaces in RA

A

stiffening due to fusion of bone - due to formation of pannus (fibrovascular tissue) in the joint space

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13
Q

what are the various causes of RA

A

genetics HLADR4
primary exogenous arthritogen eg EBV
autoimmune
mediators of joint damage - cytokines

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14
Q

what is the criteria for diagnosis of RA

A 
4 things 
morning stiffness 
arthritis hands/joints 
symmetrical 
nodules 
serum RA factor 
radiological narrowing
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15
Q

what is rheumatoid factor

A

present in most patients with RA

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16
Q

what is a more specific test for RA than rheumatoid factor

A

anti CCP - ACPA test

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17
Q

what is present in synovial fluid which tests for RA

A

neutrophils

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18
Q

what is seronegative arthritis and give example

A

lacks Rheumatoid factor

ankylosing spondylitis or reiters syndrome

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19
Q

what is the cause of infective arthritis and signs

A

bacterial staphylococcus

fever, leucocytosis and elevated ESR

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20
Q

what is GOUT and the causes

A

end point of group of disorders producing hyperuricaemia

uric acid is the end product of purine metabolism

21
Q

what are the clinical features of gout

A

acute/chronic arthritis
tophi in various sites - cyrtsallisation of rates within and about joints
gouty nephrophathy

22
Q

what is pyogenic osteomyelitis and its cause

A

systemic illness - bone destruction surrounded by sclerosis - bacterial causes
sheet of neutrophils present

23
Q

what is the risk of pyogenic osteomyelitis

A

haematogenous spread to joints

24
Q

what is osteoporosis

A

increased porosity of skeletal system - reduction in bone mass

25
Q

what are the causes and clinical features of osetoporosis

A

primary - age/menopause
secondary - hyperparathyroidism or T1DM
vertebral fractures, kyphosis scoliosis

26
Q

what is pagets disease of bone

A

dysregulated bone remodelling - excessive bone breakdown and disorganised new bone formation

27
Q

what is osteomalacia and its accuses

A

defects in matrix mineralisation - related to lack vitamin D
decreased bone density (small bones osteopenia )

28
Q

how does hyperparathyroidism affects bones

A

excessive PTH - increase bone reabsorption from skeleton = increases renal tubular reabsorption and retention of calcium = hypercalcaemia

29
Q

what is renal osteodystrophy

A

consequence of chronic renal disease - increased osteoporosis clastic bone resorption

30
Q

what types of tissues are soft tissue

A

tendons, ligaments fascia skin - not bone - mesodermal origin

31
Q 
what are these tumours tissues 
lipoma 
fibroma 
leiomyoma 
haemangioma 
lymphangioma 
neuroma
A 
fat 
fibrous tissue 
skeletal muscle 
blood vessels 
lymphatics 
peripheral nerve
32
Q

what is the most common malignant bone tumour

A

osteosarcoma

33
Q

what are these tumours
osetoma
chondroma
osteochondroma

A

benign bone tumour
benign cartilage tumour
mixed benign bone and cartilage tumour

34
Q

what is the most common site for osteosarcoma and who does it affect more

A

knee

young people

35
Q

what is ewings sarcoma

A

malignant small, round, blue cell tumour

type of bone tumour

36
Q

where to most metastatic bone tumours arise from

A

breast or prostate

37
Q

what is the classification criteria of SLE

A

american college of rheumatology
4 of
malar rash, discord rash, photosensitivity, oral ulcers, renal disorder, immune/neurolgic disorder

38
Q

what are the 4 clinical features of SLE

A

cutaneous - butterfly rash - bridge of nose and cheeks
cardiac - cardiomegaly / endocarditis
CNS - convulsions, hemiplegia
renal - nephrotic syndrome

39
Q

what is systemic sclerosis and the prognosis

A

vessel damage, inflammatory response due to cytokines
osteoarticular involvement
poor prognosis

40
Q

what is crest syndrome associated with and what is it

A

systemic sclerosis

Calincosis - calcium deposits in the skin
raynauds
oesophageal dysmobility
sclerodactyly - thinking og skin on fingers and toes
telangiectasia - spider veins

41
Q

what is polymyalgia rheumatica and what is it associated with

A

stiffening, weakness, aching, pain in neck
associated with giant cell arteritis - affects occipital or facial arteries - headache and scalp pain

immunological mechanism

42
Q

what is myopathy vs myositis

A

muscle disease unrelated to any disorder of innervation or neuromuscular junction

muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness

43
Q

describe the cause of msucular dystrophy and the features

A

genetic - progressively severe muscle weakness and wasting beginning in childhood

44
Q

what is the most common form of muscular dystrophy

A

deuchenne

45
Q

what is the pathogenesis of malignant hyperthermia

A

inherited disease

fast rise in body temp with severe muscle contraction when the affected person get general anaesthesia

46
Q

what are the complications of malignant hyperthermia

A

rhabdomyolysis and high blood potassium

47
Q

what is rhabdomyolysis and causes

A

destruction of skeletal muscle - myoglobin release into the blood and myoglobinuria = brown urine
caused by trauma, drugs, high temp

48
Q

what are two examples of metabolic myopathies

A

glycogen synthesis and degradation - disorders of mitochondrial metabolism

year 2 - clinical pathology (67 decks)

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