MSK disorders

Question 1

What’s the difference between muscle sprain and muscle strain?

Answer 1

Sprain: Stretched or torn ligament
Strain: Stretched or torn muscle or tendon

Question 2

RICE/ PRICE

Answer 2

Rest
Ice
Compression
Elevation
P- protection for further injury

Question 3

what’s epicondylitis？

Answer 3

Epicondylitis is inflammation of a tendon where it attaches to bone

Question 4

what’s tennis elbow?

Answer 4

lateral epicondylitis

Question 5

what’s golfer’s elbow

Answer 5

medial epiconydlitis

Question 6

do NOT use ___ therapy with bursitis because

Answer 6

do NOT use heat therapy
increase inflammation

Question 7

Hyperuricemia and can lead to formation of _____ crystals in joints, bones & tissues

Answer 7

monosodium urate (MSU)

Question 8

what causes gout?

Answer 8

defect in purine metabolism

Question 9

what is gout flareup？

Answer 9

Innate immune response to deposition of MSU crystals

Question 10

what happens during gout flareup？

Answer 10

Hyperplasia of synovial membrane
Cellular infiltration of neutrophils, proinflammatory cytokines (Interleukin IL1β)
Structural damage to joints

Question 11

what are the 3 clinical stages of gout?

Answer 11

1. asymptomatic
2. acute gouty arthritis
3. tophaceous gout

Question 12

rhabdomylitis is the result of disintegration of ———————— muscle

Answer 12

striated muscle (skeletal muscle)

Question 13

___ is leaked into the extracellular space during rhabdomylitis and can cause injury to ___ (organ)

Answer 13

myoglobin
injury to kidney

Question 14

With muscle injury there is a leakage of _________ (ion) into _________space

Answer 14

extracellular Ca2+ into intracellular space

Question 15

what drugs can cause rhabdomylitis

Answer 15

HMG-CoA reductase inhibitors (statins),
fibrates,
corticosteroids,
SSRIs

Question 16

what’s the key focus in treating rhabdomylitis?

Answer 16

perserving renal function

Question 17

what are the 3 types of osteoporosis?

Answer 17

Primary Type I: Postmenopausal women
Primary Type II: Senile (after age 70 years)
Secondary: Other etiologies or drugs as cause

Question 18

The most common osteoporotic fracture are _______ because they are rich in ___ bone

Answer 18

vertebral fractures
spongy bone

Question 19

what are the etiologies of osteoporosis?

Answer 19

• Decreased levels of estrogen & testosterone
• Inadequate levels of vitamin D, calcium, magnesium
• Alterations in OPG/RANKL/RANK system
• Postmenopausal osteoporosis:
  ↑osteoclast activity and changes in OPG
• Glucocorticoids:
  ↑RANKL expression, inhibit OPG production by osteoblasts causing lower bone density

Question 20

what types of drugs can cause osteoporosis?

Answer 20

glucocorticoids
SSRI
PPI
seizure medications: phenytoin (dilantin) and carbemazepine (tegretol)
Thyroid replacement
anticoagulant
immunosuppressant

Question 21

What’s the Canadian guideline for BMD testing?

Answer 21

1. All women & men ≥ 65 years
2. Postmenopausal women & men age 50-64 yrs. with risk factors for fracture
3. Young women or men (under age 50) with an existing disease associated with bone loss

Question 22

after age of ___ bone density begins to decrease

Answer 22

30

Question 23

what’s sarcopenia

Answer 23

Sarcopenia is age related loss of muscle mass & a decrease in muscle strength

Question 24

Environmental factors that cause gout?

Answer 24

Increased intake of purine rich foods (seafood, red meat)
ETOH (beer), fructose-soft drinks
Increased BMI > 25 kg/m2 (hyperinsulinemia and reduced renal clearance of urate)
Drugs (i.e. diuretics, cyclosporin, beta-blockers, low dose ASA)

Question 25

Heberden nodes

Answer 25

distal of the finger joint

Question 26

Bouchard nodes

Answer 26

proximal of the finger joint