MSK disease

Question 1

what is arthritides

Answer 1

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

Question 2

what are the acute symptoms of arthritis

Answer 2

pain, heat, redness and swelling

Question 3

what are the two most common types of chronic arthritis

Answer 3

OA and RA - pain but no heat or redness

Question 4

what is the most common type of joint disease

Answer 4

osteoarthritis - degenerative joint disease - progressive erosion of articular cartilage

Question 5

what is the cause and result of osteoarthritis

Answer 5

associated with age - no initiating cause

formation of bony spurs and cysts at the margin of joint

Question 6

which disease would you get bouchards and herberdens nodes

Answer 6

primary osteoarthritis - B = proximal nodes

H = distal nodes

Question 7

which bones are primary OA affected by

Answer 7

fingers knees C and L spines

Question 8

which types of sports are commonly affected by secondary OA

Answer 8

knee in basketball players and elbow in baseball players

Question 9

what is the pathogenesis of secondary OA

Answer 9

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

Question 10

what happens at the cellular level in secondary OA

Answer 10

chrondorcytes produce IL-1 that initiates matrix breakdown

prostaglandin derivatives induce release of lytic enzymes that prevent matrix synthesis

Question 11

what is rheumatoid arthritis and what does it affect

Answer 11

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

Question 12

what is ankylosis of joint spaces in RA

Answer 12

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

Question 13

what are the various causes of RA

Answer 13

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

Question 14

what is the criteria for diagnosis of RA

Answer 14

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

Question 15

what is rheumatoid factor

Answer 15

present in most patients with RA

Question 16

what is a more specific test for RA than rheumatoid factor

Answer 16

anti CCP - ACPA test

Question 17

what is present in synovial fluid which tests for RA

Answer 17

neutrophils

Question 18

what is seronegative arthritis and give example

Answer 18

lacks Rheumatoid factor

ankylosing spondylitis or reiters syndrome

Question 19

what is the cause of infective arthritis and signs

Answer 19

bacterial staphylococcus

fever, leucocytosis and elevated ESR

Question 20

what is GOUT and the causes

Answer 20

end point of group of disorders producing hyperuricaemia

uric acid is the end product of purine metabolism

Question 21

what are the clinical features of gout

Answer 21

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

Question 22

what is pyogenic osteomyelitis and its cause

Answer 22

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

Question 23

what is the risk of pyogenic osteomyelitis

Answer 23

haematogenous spread to joints

Question 24

what is osteoporosis

Answer 24

increased porosity of skeletal system - reduction in bone mass

Question 25

what are the causes and clinical features of osetoporosis

Answer 25

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

Question 26

what is pagets disease of bone

Answer 26

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

Question 27

what is osteomalacia and its accuses

Answer 27

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

Question 28

how does hyperparathyroidism affects bones

Answer 28

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

Question 29

what is renal osteodystrophy

Answer 29

consequence of chronic renal disease - increased osteoporosis clastic bone resorption

Question 30

what types of tissues are soft tissue

Answer 30

tendons, ligaments fascia skin - not bone - mesodermal origin

Question 31

``` what are these tumours tissues lipoma fibroma leiomyoma haemangioma lymphangioma neuroma ```

Answer 31

``` fat fibrous tissue skeletal muscle blood vessels lymphatics peripheral nerve ```

Question 32

what is the most common malignant bone tumour

Answer 32

osteosarcoma

Question 33

what are these tumours osetoma chondroma osteochondroma

Answer 33

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

Question 34

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

Answer 34

knee | young people

Question 35

what is ewings sarcoma

Answer 35

malignant small, round, blue cell tumour | type of bone tumour

Question 36

where to most metastatic bone tumours arise from

Answer 36

breast or prostate

Question 37

what is the classification criteria of SLE

Answer 37

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

Question 38

what are the 4 clinical features of SLE

Answer 38

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

Question 39

what is systemic sclerosis and the prognosis

Answer 39

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

Question 40

what is crest syndrome associated with and what is it

Answer 40

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

Question 41

what is polymyalgia rheumatica and what is it associated with

Answer 41

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

Question 42

what is myopathy vs myositis

Answer 42

muscle disease unrelated to any disorder of innervation or neuromuscular junction muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness

Question 43

describe the cause of msucular dystrophy and the features

Answer 43

genetic - progressively severe muscle weakness and wasting beginning in childhood

Question 44

what is the most common form of muscular dystrophy

Answer 44

deuchenne

Question 45

what is the pathogenesis of malignant hyperthermia

Answer 45

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

Question 46

what are the complications of malignant hyperthermia

Answer 46

rhabdomyolysis and high blood potassium

Question 47

what is rhabdomyolysis and causes

Answer 47

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

Question 48

what are two examples of metabolic myopathies

Answer 48

glycogen synthesis and degradation - disorders of mitochondrial metabolism