Brainscape's Knowledge GenomeTM

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


See full index

3a > MSK + Rheumatology > Flashcards

MSK + Rheumatology Flashcards

1
Q

What are the risk factors for developing mechanical back pain?

A 
Heavy manual handling 
Female
Older age 
Fibromyalgia
Stress
Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the clinical features of mechanical back pain?

A

Pain that starts suddenly
Pain relieved by rest
Precipitated by injury
Stiff back

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

What are the red flags of back pain?

A 
Acute onset in elderly
Nocturnal pain
Worse pain on being supine
Fever
Night sweats
Weight loss
Abdominal mass
History of malignancy 
Neurological disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How would you manage mechanical back pain?

A

Avoid prolonged inactivity
Analgesia
Physiotherapy

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

Name the three key signs of cauda equina compression.

A
  1. Alternating or bilateral root pain in legs
  2. Bladder + bowel incontinence
  3. Saddle anaesthesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fibromyalgia is a chronic condition that causes pain, fatigue and muscle ache. What are the psychosocial risk factors for this?

A 
Divorced
Female sex
Sickness behaviours
Social withdrawal
Stress
Lack of social support
Low household income
Low educational status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which medical conditions are associated with fibromyalgia?

A

IBS

Depression

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

What are the symptoms of fibromyalgia?

A 
Sleep disturbance 
Chronic widespread pain with no inflammation
Severe fatigue
Low mood
Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you manage fibromyalgia?

A

Amitriptyline
CBT
Exercise programmes

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

What are the crystals in gout made out of?

A

Monosodium urate

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

What are the risk factors for developing gout?

A 
Obesity
High dietary purines
Alcohol excess
Diuretics
Hypertension
DM
Chronic renal failure - kidneys fail to excrete uric acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the signs of gout?

A

Monoarthritis - tends to be one joint
Swollen joint
Red shiny joint
Tophi - onion like aggregates of urate crystal

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

What investigations can you do to diagnose gout?

A

Serum urate
Polarized light microscopy - negatively birefringent urate needle shaped crystals
X-ray

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

What are the features of gout on an X-ray?

A

Soft tissue swelling

Erosions in juxta-articular bone

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

How would you manage gout?

A

NSAIDs
Colchicine - can cause diarrhoea
Steroids

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

Outline prophylaxis for gout.

A

Allopurinol
Lose weight
Cut down alcohol and purine reach foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of crystals manifest in pseudo-gout?

A

Calcium pyrophosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for developing pseudo-gout?

A

Old age
Hyperparathyroidism
Haemachromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How would pseudo-gout appear on light microscopy?

A

Positive birefringent rhomboid shaped crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which gene is rheumatoid arthritis associated with?

A

HLA-DR4/DR1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In RA, there is chronic inflammation of the joints, leading to joint space narrowing. What are the symptoms of RA?

A 
Swollen painful joints - worse in morning 
Morning stiffness >30 mins
Pain improves with activity 
Fatigue
Fever 
Weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the signs of RA?

A 
Rubor = redness
Calor = Heat
Tumour = swelling 
Dolor = pain

Symmetrical polyarthritis
Ulnar deviation of fingers
Boutonniere and swan-neck deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the extra-articular signs of RA?

A 
Sicca = dry eyes
Nodules on elbows
Lymphadenopathy 
Vasculitis 
Carpal tunnel syndrome 
Peripheral neuropathy
Scleritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What investigations would you do to diagnose RA?

A

FBC: anaemia of chronic disease
ESR/CRP
Rheumatoid factor
anti-CCP antibodies

25
Q

How would RA appear on an x-ray?

A

Soft tissue swelling
Loss of joint space
Juxta-articular osteopenia
Bony erosions

26
Q

How would you manage RA?

A 
Methotrexate
Sulfasalazine 
Hydroxychloroquine 
Gold injections 
TNF-a inhibitors 
Intra-articular steroid injections
Rituximab (anti-CD20)
Physiotherapy
Surgery in severe cases
27
Q

A DMARD is a disease-modifying anti-rheumatic drug. What is the major side effect of these drugs?

A

Immunosuppression

28
Q

Which drug needs to be prescribed with methotrexate?

A

Folic acid 5mg

29
Q

What are the adverse effects of methotrexate?

A

Mouth ulcers
Pulmonary fibrosis
Leukopenia
Teratogenic

30
Q

What are the adverse effects of sulfasalazine?

A

Male infertility

31
Q

What are the adverse effects of rituximab?

A

Night sweats

Thrombocytopenia

32
Q

Polymyalgia rheumatica is an inflammatory condition that causes pain and stiffness in the shoulders, pelvic girdle and neck. Which condition is this associated with?

A

Giant cell arteritis

33
Q

What are the symptoms of polymyalgia rheumatica?

A 
Bilateral shoulder pain that may radiate to elbow
Bilateral pelvic girdle pain
Pain worse on movement 
Pain interferes with sleep
Morning stiffness >45 mins
Weight loss
Fever 
Pitting oedema 
Carpel tunnel
34
Q

Polymyalgia rheumatica is usually diagnosed after excluding other conditions. Along with routine bloods and x-ray, how would you confirm polymyalgia rheumatica?

A

Assess response to steroids

35
Q

Outline the Don’t STOP plan for patients on long term steroids.

A

Don’t: - Patients should not stop taking steroids due to risk of adrenal crisis
S - sick day - increase steroids if patient becomes sick
T - treatment card
O - osteoporosis prophylaxis with bisphosphonates, calcium and Vitamin D
P - proton pump inhibitor

36
Q

What are the risk factors for osteoarthritis?

A 
Obesity
Age
Occupation
Trauma
Female 
FH
37
Q

Why is obesity a risk factor for osteoarthritis?

A

Obesity is a low grade inflammatory state, with the release of IL-1 and TNF. Both of these cytokines mediate OA

38
Q

What are the symptoms of osteoarthritis?

A

Joint pain on movement
Stiffness
Functional impairment n ADLs
Pain worse at end of day

39
Q

What are the signs of osteoarthritis?

A 
Asymmetrical joint 
Gait alteration
Crepitus
Tenderness
Morning stiffness <15 mins 
Herderden's nodes at DIP joints
Bouchard's nodes at PIP joints 
Cyst formation
Reduced range of movement
40
Q

What are the signs of osteoarthritis on x-ray?

A 
LOSS:
L - loss of joint space 
O - osteophytes
S - subchondral sclerosis 
S - subchondral cysts
41
Q

What is the non-medical management of osteoarthritis?

A

Exercise
Weight loss
Physio
Walking aids

42
Q

What is the pharmacological management of osteoarthritis?

A

NSAIDs
Opiates
Intra-articular steroid injections

43
Q

What is the surgical management of osteoarthritis?

A

Joint replacement

44
Q

What is osteoporosis?

A

Decreased bone density

45
Q

What are the risk factors for osteoporosis?

A 
SHATTERED
S - steroid use
H - hyperthyroidism, hyperparathyroidism 
A - alcohol + tobacco
T - thin, BMI <22
T - testosterone low (female)
E - early menopause
R - renal or liver failure
E - erosive bone disease - RA
D - dietary low calcium
46
Q

Which hormone protects against osteoporosis?

A

Oestrogen

47
Q

What does the FRAX tool predict?

A

Risk of fragility fracture over next 10 years

48
Q

Which scan is used to measure bone mineral density?

A

DEXA scan

49
Q

What T scores would you expect for someone with normal BDM, osteopenia and osteoporosis?

A 
Normal = > -1
Osteopenia = -1 to -2.5
Osteoporosis = < -2.5
50
Q

Which medical conditions are asked about in the FRAX score?

A 
RA
Kidney failure
Cushing's
Coeliac disease
MS
Hyperthyroidism
Hyperparathyroidism
Diabetes
Previous fracture
51
Q

Which medications are asked about in the FRAX score?

A

Glucocorticoids
Lithium
Barbiturates

52
Q

Which FH is asked about in the FRAX score?

A

Parental fractured hip

53
Q

What social history is asked about in the FRAX score?

A

Smoking status

Alcohol units

54
Q

Which personal information is asked about in the FRAX score?

A 
Age
Sex
Weight
Height
Femoral neck BMD
55
Q

Which lifestyle changes would you advise for someone with osteoporosis?

A 
Exercise
Quit smoking 
Reduce alcohol
Maintain healthy weight
Adequate calcium and vitamin D
56
Q

What is the first line medical treatment for osteoporosis and how does this work?

A

Bisphosphonates - reduce osteoclast activity, preventing reabsorption of bone

57
Q

What are the side effects of bisphosphonates?

A

Reflux

Oesophageal erosions

58
Q

What second line medications can be given for osteoporosis?

A

Denosumab - monoclonal antibody to RANK ligand
Strontium ranelate
Teriparatide
HRT

3a (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions