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Final year semester 2 exam > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What are condroitin sulphate chains made of?

A

Glucosaminoglycans

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2
Q

What are proteoglycans made of, and what is it attached to? (found in extracellular matrix)

A

Condrotin sulphate, attached to hyluronic acid

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3
Q

What does glucosamine do in regards to extra cellular matrix?

A

makes the body produce more proteoglycans

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4
Q

What do chondrocytes do?

A
  • maintain cartilage
  • support growth and repair
  • regulate nutrients
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5
Q

What happens with chondrocytes to cause OA?

A

excessively breaking down cartilage and not doing a good enough job of rebuilding it

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6
Q

name some risk factors for OA

A
  • injury
  • obesity
  • genetics
  • diabetes (high insulin)
  • chronic inflammation
  • nutritional deficiencies
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7
Q

What are side effects NSAIDs, explain the mode of action

A

NSAIDs inhibit prostaglandin production via the COX pathway to reduce pain and inflammation. Prostaglandins are also responsible for the mucosal lining in the GIT system, so if they are inhibited they can cause thinning of the mucosal lining resulting in gastric ulceration.

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8
Q

What changes to fats would you make for someone with OA

A
  • lowering arachadonic acid (diary, eggs and meat) as it’s a precursor for PGE2.
  • EPA for PGE3 activation (anti-inflammatory) with oily fish, supplement fish oil or Omega-3, spirulina, chlorella, chia seeds, flax seeds
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9
Q

How can glucosamine sulphate help with OA? RD?

A
  • used for GAG = proteoglycan synthesis
  • provides sulphate ions for the production of condroitin sulphate
  • Inhibits MMPs by inhibiting NF-kB, reducing cartilage breakdown.

RD: 500mg x 3 daily

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10
Q

How can chondroitin sulphate help with OA? RD?

A
  • increases hyaluronic acid
  • inhibits cartilage degrading enzymes

RD: 200-400 mg/day

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11
Q

How can vitamin D help with OA? RD?

A
  • prevents erosion of cartilage by supporting collagen turnover
  • anti-inflammatory (IL-6 and TNF-a)

RD: 2000-10,000 IUD depending on test levels

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12
Q

Name some other supplements that can help with OA

A
  • tart cherry
  • vitamin K
  • MSM
  • vitamin E
  • boswellia
  • devils claw
  • ginger
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13
Q

How can turmeric help with OA? RD?

A

inhibits NF-kB and IL-1b and IL-6

RD: 500-2000 mg/day

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14
Q

Which tissue salts with you recommend for OA?

A
  • Ferrum phos
  • Calc phos
  • Nat phos
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15
Q

What are some complications of RA?

A
  • pleurisy
  • kidney disease
  • C 1/2 vertebral subluxation
  • pulmonary fibrosis
  • carpal tunnel syndrome
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16
Q

What is citrillination?

A

when we convert Arginine into citrine

17
Q

Which 2 genetic SNPs relate to RA?

A
  • HLA-DRB1 (largest genetic risk factor for RA)
  • PTPN22
18
Q

Why is smoking such a big risk for RA?

A
  • oxidative damage
  • activation of pro-inflammatory cytokines such as IL-17
  • raised MMP expression
  • epigenetic changes
  • increase citrilliantion
19
Q

which enzyme is produced by periodontitis that causes citrillination?

A

PAD (Peptidylarginine deiminase)

20
Q

Which bacterias are found in large amounts in people with RA

A

Pervotella copri, and collinsella

21
Q

What blood test findings may you get with RA

A
  • raised ESR/CPR
  • Rheumatoid factor
  • ACPAs (can appear 10 years before RA)
  • Anaemia
22
Q

What are the conventional treatments for OA

A
  • NSAIDs
  • methoterxate
23
Q

How can resveratrol help with RA? RD?

A
  • down-regulates NF-kB and COX-2
  • inhibits angiogenesis
  • reduces T-17 cells

RD: 200 mg/day

24
Q

How can vitamin D help with RA? RD?

A
  • inhibits T-17
  • promotes cell differentiation
25
Q

What is gout?

A

accumulation of monosodium urate (MSU) causing inflammation in the joint

26
Q

How can ALA help with RA? RD?

A
  • helps the creation of intracellular Glutathione production (RA sufferers have low antioxidants)
  • anti-inflammatory (NF-kB, COX-2)

RD: up to 1,200 mg/day

27
Q

Which SNP is related to Gout?

A

ABCG2

28
Q

Which enzyme converts purines to uric acid?

A

Xanthine oxidase (XO)

29
Q

How does quercitin help Gout?

A
  • inhibits xanthine oxidase
  • promotes activity of urate excretion channels
  • blocks IL-1b pathway (main Gout inflammatory enzyme)
  • inhibits LOX
30
Q

How does Mg help with Fibromyalgia?

A
  • down-regulates the NMDA pathway inhibiting glutamate, which is responsible for pain. Zinc also does this.
31
Q

How does Vitamin D help with Fibromyalgia?

A
  • modulates centeal pain processing
  • inhibits PGE2
  • reduces inflammatory cytokines
32
Q

How does B6 help with Fibromyalgia?

A

co-factor for glutamate decarboxylase, needed for the conversion of glutamate to GABA

33
Q

What is the main genetic SNP for AS?

A

HLA-B27

34
Q
A
35
Q
A

Final year semester 2 exam (9 decks)

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