Brainscape's Knowledge GenomeTM

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


See full index

brs > Musculoskeletal And Rheumatology > Flashcards

Musculoskeletal And Rheumatology Flashcards

1
Q

Name the connective tissue surrounding muscle, muscle fascicles and muscle fibre

A

Epimysium surrounds muscle
Perimysium surrounds muscle fascicle
Endomysium surrounds muscle fibre

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

What is a sarcomere

A

The repeating unit on a myofibril from one Z disc to another Z disc

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

Describe the functional classification of joints

A

Synarthroses - generally allow no movement
Amphiarthroses - allow v limited movement
Diarthroses - allow free movement

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

What are the components of a snyovial joint and describe each of them

A

Synovium

  • 1 to 3 cells thick
  • contains type A synoviocytes (phagoctic and macrophage-like) and type B synoviocytes (fibroblast-like and produce hyaluronic acid)
  • contains Type I collagen

Synovial fluid
- Hyaluronic acid-rich viscous fluid

Articular Cartilage

  • contains Type II collagen
  • contains Proteoglycan (aggrecan)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What us cartilage composed of

A

Chondrocytes

ECM: water, collagen, proteoglycans (maily aggrecan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Whta is aggrecan and what is it characterised by

A

Proteoglycan with many chondroitan suplhate and keratin sulphate chains
Characterised by its ability to interact with Hyaluronan (HA) to form large proteoglycans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

2 main pathological chnages of osteoarthritis

A 
Cartilage degeneration
Bony remodelling (leads to formation of osteophytes/bony spurs. Osetopenia and bone erosion is therefore for RA not OA, also this is why swelling for OA is bony as oppose to effusion and red/hot for RA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which joints are typically affected in OA?

A

Joints of hand: DIP, PIP, CMC
spine
Weight-bearing joints of the lower limbs: knees, hips, first MTP

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

Sings and symptoms of osteoarthritis

A 
Joint enlargement -Bouchards nodes (PIP) and Heberdens (DIP) 
Joint stiffness after immobility
Joint crepitus
Joint instability 
Joint pain 
Limitations of range of motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Main method of diagnosing OA

A

X ray

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

5 c,inical manifestations of inflammation

A 
Calor (heat)
Dulor (pain)
Tumor (swelling) 
Loss of function 
Rubor (redness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Physiological cellular and molecular chnages that occur during inflammation

A

Increased blood flow
Migration of leucocytes to the tissue
Activation and differentiation of leucocytes
Cytokine production

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

Causes of inflammatory joint disease

A

1) infection
- TB (chronic)
- septic arthritis (acute)

2) crystal arthritis
- gout
- pseudogout

3) immune mediated/autoimmune
- psoriatic arthritis
- rheumatoid arthritis
- SLE
- reactive arthritis

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

Risk factors for septic arthritis

A

Immune suppressed
Pre existing joint damage
Intarvenous drug user

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

How many joints are usually affected in septic arthritis and what is the main exception

A

1 joint - monoarthritis

Exception = gonococcal septic arthritis causes polyarthritis

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

When to consider septic arthritis for a patient

A

Fever

Red hot and painful swelling of joint

17
Q

Which bacteria are commonly reposnsible for septic arthritis

A

Staphylococcus aureus
Streptococcus
Gonococcus

18
Q

How can you treat septic arthritis

A

Lavage (wash out)

IV antibiotics

19
Q

Causes of hyperuracaemia

A
  • foods rich in purine foods
  • kidney failure (reduced excretion of uric acid)
  • genetic tendancy
20
Q

Risk factors for pseudo gout

A

Age (elderly)
Background OA
Intercurrent infection

21
Q

Strong radiographic indicator of gout

A

Juxta articular rat bite erosions

Juxta articular means near a joint

22
Q

Clinical features of gout

A 
Acute monoarthritis (commonly Podagra: gout of foot eso big toe - first MTP joint)
Joints in feet, ankles, knees, wrists, elbows and fingers affected 
Crystal deposits (tophi) - yellowish appearance
23
Q

3 key features of RA

A

1) chronic arthritis
- symmetrical
- morning stiffness
- joint erosion
- polyarthritis

2) extra articular disease
- vasculitis
- episcleritis
- subcutaneous nodules

3) prescence of rheumatoid factor in blood

24
Q

Pattern of joint involvment in RA

A 
Symmetrical
Polyarthritis 
MTP
PIP
CMC 
wrists 
Knees
25
Q

What is inflammation of bursa in elbow called

A

Olecranon bursitis

26
Q

What 3 areas of synovium can RA happen

A
  • synovial joints
  • tenosynovium
  • bursa
27
Q

Feltys syndrome

A

Triad of RA, leucopenia and splenomeglay

28
Q

Common and uncommon extra articular features of RA

A

Common

  • weight loss
  • fever
  • subcutaneous nodules

Uncommon

  • vasculitis
  • episcleritis
  • lung disease
  • amyloidosis
  • neuropathies
  • feltys syndrome
29
Q

What causes the synovium to become proliferated mass of tissue (pannus) in RA

A

neovascularisation
Lymphangiogenesis
Inflammtory cells
Excess of pro inflmmatory cytokines vs anti inflammtary cytokines

30
Q

2 types of autoantibodies found in blood of pt with RA

A

1) rheumatoid factor - antibody (usually IgM) against Fc region of IgG
2) antibody against citrullinated protein antigens (ACPA) - v specific and formed by PAD (peptidyl arginine deaminase)

31
Q

Whta drugs are used for RA (1st and 2nd line treatments)

A

1st : methotrexate with hydroxychloroquine or with sulfasalazine
2nd : biological therapy (protein targetting another protein and can have 1 of 4 effects:
1) Inhibits TNF alpha
2) B cell depletion
3) modulates T cell costimulation
4) inhibits IL6 signalling

32
Q

What is the difference in joint space narrowing in OA vs RA

A

OA: it is a primary abnormality
RA: it is caused by secindary damage due to synovitis

33
Q

Classical clinical presentation for psoriatic arthritis

A

Assymetrical arthritis affecting the IPJs

34
Q

What else can psoriatic arthritis manifest as other than classical presentation

A

Symmetrical involvement of small joints
Spine and sacroiliac joint inflammation
Oligoarthritis of large joints
Arthritis mutilans

35
Q

Clinical test for SLE

A

Anti nuclear antibody test

  • negative confirms its NOT SLE
  • positive does not confirm SLE

anti double stranded DNA antibody test
-positive is a strong indicator of SLE in context of the relevant clinical presentation

36
Q

Reactive arthritis may be first signs of which infections

A

HIV

Hep C

37
Q

Difference between septic and reactive arthritis

A 
Septic = as a result of infection of synovium 
Reactive = sterile inflammatory effects due to a previous infection but there is not infection of the joint itself
38
Q

3 stages of fracture management

A

Reduce
Rehabilitate
Hold

brs (8 decks)

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