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PRIYA MSK BASICS > MSK summary basic principles > Flashcards

MSK summary basic principles Flashcards

1
Q

SLE antibodies

A 
ANA
antiDNA
Anti SM 
anti Ro 
anti rNP
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2
Q

sjorgens antibodies

A

ANA
anti RO
anti la

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3
Q

systemic sclerosis limited antibody

A

anticentromere

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4
Q

systemic sclerosis diffuse anibody

A

anti scl 70

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5
Q

small vessel vasculitis antibodies

A

ANCA

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6
Q

what happens when Ca2+ binds to troponin on actin filaments?

A

tropomyosin is moved to uncover cross bridge binding sites on actin

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7
Q

what happens cellularly in rigor mortis?

A

no ATP present so myosin head remains attached to actin fibre

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8
Q

example of isotonic contractions?

A

body movements and moving objects

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9
Q

example of isometric contractions

A

supporting objects in fixed positions and maintaing body posture

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10
Q

do skeletal muscles have a neuromuscular junction?

A

yes

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11
Q

do skeletal muscles have a gap junction

A

no

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12
Q

where do skeletal muscles get CA from

A

entirely sacroplasmic retinculim

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13
Q

where do cardiac muscels get CA from

A

ECF and sacroplasmiic reticulum

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14
Q

what are the 3 metabolic pathways which supply ATP in muscle fibres?

A 
creatine phosphate (transfer of high energy phosphate from creatine phosphate to ADP) 
oxidative phosphorylation (main source when O2 is present) 
glycolysis (main source when O2 is not present)
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15
Q

describe type 1 muscle fibres

A

slow twitch
prolonged, low work eg walking
abundance of myoglobin + mitochondria

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16
Q

decsirbe 2a type muscles fibres

A

fast oxidative
prolonged moderate work eg jogging
uncommon

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17
Q

describe type 2b muscle fibres

A

fast glycocytic
short term, high intensity work eg jumping
fatigue early
few mitochondria + less myoglobin than T1

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18
Q

what is the sensory receptor of the stretch reflex

A

muscle spindle

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19
Q

what is the stretch reflex

A

a negative feedback that resists a passive change in muscle length to maintain optimal resting length of muscle

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20
Q

which fibres are sound in muscle spindle and how do they run

A

intrafusal fibres

found in muscle belly and run parallel to extrafusal fibres (normal fibres)

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21
Q

what are the sensory nerve endings of muscle spindles called

A

annulospiral fibres

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22
Q

what is the efferent nerve supply of muscle spindles

A

gamma motor neurones

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23
Q

which components of hyaline cartialge act as elassticy and reduce friction

A

water + proteoglycans

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24
Q

what is the definitoin of OA

A

articular cartilage thinning or loss

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25
Q

early vs late events of OA

A

early - injury to chondrocytes + matrix, fibrillation

late - inflammaotry changes in synovium + subchondral bone –> bone on bone

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26
Q

which scale is used for OA

A

kellgren - lawrence

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27
Q

surgical treatment for OA

A

THA

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28
Q

what causes reactive arthritis

A

chlamydia, shigella and salmonella

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29
Q

what is the cause of enteric arthritis

A

organisms with high lipopolysaccharides in cell wall trigger immune reaction

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30
Q

what bug causes infectious arthritis in kids

A

h influenza

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31
Q

what bus causes infectious arthritis in adults

A

staph aureus

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32
Q

explain the mechanisms behind increased uric acid synthesis?

A

diet -> purines -> xanthine -> uric acid

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33
Q

what causes hyperuriacemia?

A

idiopathic 90%
HGORT enzyme deficiency (lesche nyhans syndrome)
increased cell turn over eg cancer and psoriasis

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34
Q

causes of reduced excretion of uric acid?

A

thiazide diuretics

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35
Q

definition of gout

A

inflammatory arthriis caused by deposition of uric acid in joints
>0.42mmol/L

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36
Q

how is uric acid excreted normlally

A

2/3rds from renal

1/3rds from GI

37
Q

what causes gout?

A

joints of lower temperature (decreases solubility of urate)
duration of hyperuricaemia
loop diuretics eg furesomide

38
Q

what is gouty tophus

A

deposition in soft tissues

39
Q

histology findings of tophus

A

amorphous eosinophilic debris + inflammation (giant cells)

pyrophosphate arthropathy

40
Q

side effect of colcichine

A

diarrhoea

41
Q

how does allopurinol work

A

xanthine oxidase inhibitor

start it 2-4 weeks after acute attack

42
Q

which cartilage does calcium pyrophosphate / gout affect

A

fibrocartilge eg knees, wrists, ankles

43
Q

which type of pseudo gout causes milwaukee shoudler

A

calcium hydroxyapatite crystals

females 50-60

44
Q

grading score for joint hypermobility syndrome

A

modified beighton score

45
Q

definitoin of OP

A

quantitive defect

decreased BMD and increased porosity

46
Q

features of type 1 OP

A

post menopausal

colles fracture

47
Q

features of type 2 OP

A

secondary / old age / alcohol

femoral neck frcature + vertebral fractures

48
Q

casues of OP

A

decreased OB

decreased physcial acivity

49
Q

biochem of OP

A

decreased Ca
increased PTH
decreased vit D

50
Q

what is the causes of osteomalacia

A

softer bones -> fracture

decreased vit d (vit d sitmulates aborption of ca)

51
Q

roles of PTH

A

activates OC (releases calcium from bone)
increases resorption of calcium by renal tubules
increases urinary phosphate excretion

52
Q

which non-tumour is associated with hyperparathyroidism?

A

brown tumour

53
Q

what is the biochem of hypeparathyroidism

A

increased PTH and increased Ca

54
Q

what happens in secondary hyperparathyroidism?

A

overproduction of PTH secondary to hypercalcemia

55
Q

what happens in tertiary hyperparathyroidism?

A

chronic secondary >develops an adenoma which continues to produce PTH despite biochemical correction

56
Q

what happens in pagets disease of bone?

A

abnormality of bone turn over > thick excess bone > increased metabolism

57
Q

what are the genetic behind pagets?

A

SQSTM1 / p62

58
Q

what are the 3 stages of pagets

A

osteolytic
mixed (OB and OC activity)
osteosclerotic

59
Q

what are the extra manifestations of pagets?

A

warm skin
AV shunt
heart failure

60
Q

secondary malignnacies of pagets

A

osteosarcoma

fibrosarcoma

61
Q

pathophysiolgy of myasthenia gravis

A

auto-IgG binds with ACH receptors on muscle cells

62
Q

what can cause myasthenia gravis

A

thymic tumour 10%

63
Q

diangosis of myasthenia gravis

A

anti AChR IgG in serum + NMJ dysfunction

64
Q

treatment of myasthenia gravis

A

increase neurotranmission - pyridstigmine
surgery - if thymic tumour
immunosuppression - corticosteroids

65
Q

where are nuclei found in skeletal muscles

A

at peripheries of ibres, ust under sarcolemma (cell membrane of muscle fibres)

66
Q

what are fascices

A

bundles of muscle fibres

67
Q

what is epimysium

A

connective tissue which surrounds whole muscle

68
Q

what is perimysium

A

surrounds single fasicle

69
Q

what is endomysium

A

surrounds single fibre

70
Q

where are chondrocytes found

A

lacuna

71
Q

describe hyaline cartilage

A

blue-white
translucent
most common

72
Q

decsribe elastic cartilage

A

light yellow

flexible

73
Q

describe fibrocartialge

A

T1 collagen
chondrocyytes
cartliaginous Ecm
white

74
Q

what is the composition of bone

A

65 % hydroxyapatite
23% collagen
10% water
2% non-collagen proteins

75
Q

what is the epiphysis

A

cancellous or trabecular bone

76
Q

what is diaphysis

A

cortical bone

77
Q

what are osteoproginator cells

A

located on bone surfaces eg under periosteum, pool of reserve OBs

78
Q

what secretes osteoid

A

OB

79
Q

types of pain

A

transduction
transmission
modualtion
perception

80
Q

what is transduction pain

A

translation of noxious stimulus into electrical activity at the peripheral nociceptor

81
Q

what is transmission pain

A

propagation of pain signals as nerve impulses through the nervous system

82
Q

what is modulation pain

A

hidering of pain by opiates

83
Q

what is perception pain

A

concious experience of pain

84
Q

what are nociceptors

A

first order neurone / aferent sensory neurones

85
Q

where are nociceptors found

A

dorsal horn of spinal cord

86
Q

what is the neurotransmitter of nociceptors?

A

glutamate + peptides

87
Q

what are the 2nd order neurones in the nociceptive pathway?

A

the spinothalamic tract (pain perception) + the spinoreticular tract (autonomic respone to pain, arousal, emotional response + fear of pain)

88
Q

A$ subtype nociceptor

A

mechnical / thermal
thinly myelinated
conduction velocity 6-20ms-1
mediate first / fast pain

89
Q

C fibres nociceptor

A

unmyelinted
conduction velocity 0.5-2ms-1
all noxious stimuli (polymodal )
mediate slow or secondary pain eg burning, throbbing, cramping, aching sensations

PRIYA MSK BASICS (8 decks)

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