Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2a RRS > MSK fibromyalgia, crystal arthro > Flashcards

MSK fibromyalgia, crystal arthro Flashcards

1
Q

what is fibromyalgia

A

a neurosensory disorder characterised by chronic musculocutaneous pain
WIDESPREAD body PAIN over 3 months

Pain without any inflam
(FUNCTIONAL DISORDER w/o organic cause - clam & IBS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prevalence and epidemiology of fibromyalgia

A

4% 10F=M
Female, middle aged, divorced, low household income
RA (12% also have fibromyalgia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

cause of fibromyalgia

A

no spec pathology

central disturbances in pain processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DDx of fibromyalgia

A

RA, SLE, hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is assos with fibromyalgia

A 
chronic headache
IBS
chronic fatigue
poor sleep
depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Rf of fibromyalgia

A 
Female, 
middle aged, 
divorced, 
low household income
RA (12% also have fibromyalgia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

symptoms of fibromyalgia

A

wise spread pain, fatigue, sensitivity to pain
“fibro fog” - poor sleep (insomnia), memory, concentration
assos morning stiffness less than 1hr
pain worse in with cold or stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

signs of fibromyalgia

A

signs of tenderness (11/18 tender point sites on digital palpitation)
no signs of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx of fibromyalgia

A

by exclusion (all tests return negative
exclude RA Myeloma Infection PMR)
pain at 11/18 tender point sites on digital palpatition
(base of skull, upper outer gluteal quadrant, neck n shoulder, hip bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Managment of Fibromyalgis

A

HOLLISTIC couciling CBT, cardio exercise
amitriptyline - help sleep, anti depressants
pregabalin, gabapentin - anticonvulsants, anxiety

(Analgeisa and analgesic ladder, Tramadol
SSRI dont work too well )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is gout

A

inflam arthritis assos w hyperuricaemia and intraarticular monosodium urate crystals
deposits into tissues (esp 1st metatarsal joint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the 2 types of Crystal arthropathy and their composition

A

Gout: uric acid (monosodium urate crystals)
Pseudogout: Calcium pyrophosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of gout (principles)

A

increased intake of uric acid

decreased excretion of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

causes of gout

A

(INTAKE)
increased purine consumption - beer, shellfish, fructose
increased cell turnover - chemo, leukaemia, psoriasis

(EXCRETION)
chronic kidney disease
drugs - thiazide diuretics
dehyrdation - alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why does increased purine consumption cause gout

A

gets converted to uric acid when dna brocken down - excreted into urine or urate ion binds with Na+ – monosodium urate crystals (=GOUT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is chronic polyarticular gout

A

due to long term diueretic use in renal failure

17
Q

what is trophaceous gout

A

persistently high uric acid levels - trophi forms from monosodium urate = crystal aggregates and inflam cells

18
Q

Cfs of gout (acute)

A

inflam signs - Red/swollen/painful/hot/ loss of function –
monoarthropathy
fever
usually MTP of big toe

19
Q

Investigation of gout

A

POLARISED LIGHT MICROSCOPY - NEG bi refingent need shaped crystals
high serum urate - may be noramal is post episode
aspirate joint - excl septic arthritis

20
Q

RFs of gout

A

obesity, diabetes, fam hx, hypertension

21
Q

what is a tophus

A

chalky subcutaenous nodule (chronic trophaceous gout)

22
Q

gout pseudo gout mono or poly articulaar

A

gout =monoarticular

pseudo = Poly articular (PP)

23
Q

what joint affected in gouts vs pseudo gout

A

gout = 1st MTPJ

pseudo - knee (larger joints)

24
Q

cystal in gout v pseudo and polarised light microscopy result

A 
gout = monosodium urate (NEG BIFRINGENCE)
pseudo = calcium pyrophosphate (POS BIFRINGENCE)
25
Q

polarised light microcopy gout vs pseudo gout

A 
gout = neg needle shaped (NN)
pseudo = pos rhomboidal
26
Q

Mx off gout

A 
lifestyle - weight, alcohol, avoid purine foods (dairy = protective)
high dose NSAIDs - naproxen, ibruprofen OR COX INHIB - aspirin
COLCHICINE (targets crystallisation) - SE = abdo pain diarrhoea
or CORTICOSTEROIDS (prednisolone)
PREVENTION - ALLOPURINOL (tx for tumour lysis also) not within 1 month of attack
27
Q

prevention of gout

A

allopurinol (post 1 month of attack)

=xanthineoxidase inhib

28
Q

what is protective of gout

A

dairy foods

29
Q

what is pseudo gout

A

calcium pyrophosphate crystals deposited on joint surface - shed into joint= acute synovitis (resmebles acute gout)

30
Q

X ray changes on chronic gout

A

Punched out cortex

31
Q

CFs of pseudo gout

A

poly articular
knee/wrist
hot joint fever (similar to gout presentation)

32
Q

DDx

A

septic arthritsi

exl w aspiration and culture

33
Q

Dx of pseudo gout

A

polarised light microscopy - POS birefringence - small rhomboidal crystals
Purulent joint fluid - culture to excl septic arthritis
Xray - chonedrocalceriosis
bloods - high WCC

34
Q

Rfs of pseudogout

A 
elderly woman
joint injury or trauma 
HYPERPARATHYROIDISM
osteoarthritis
HAEMOCHROMATOSIS
35
Q

assos of psuedo gout

A

haemochromatosis
hyperparathyroidim
osteoarthritis

36
Q

features of chronic gout

A

excess uric acid deposition throughout forming tophi

37
Q

Prevalence of gout n epidem

A

commonest cause of arthritis in men <40 YO

1%

38
Q

Tx of pseudogout

A

symptomatic
Cool, rest
NSAID if CI give colchicine (like in gout)
steroid injections

39
Q

which is milder gout or pseudo

A

pseudo

2a RRS (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions