musculoskeletal disorders

Question 1

number of joints effected - which words are used?

Answer 1

mono - 1 at a time, oligo - fewer than 5 joints in the first 6 months the child has the disease, poly (5 or more joints are effected)

Question 2

what is the most common arthritis?

Answer 2

osteoarthritis

Question 3

what is the cause of the pain in osteoarthritis?

Answer 3

low grade inflammation causes joint pain caused by wearing of the cartilage. Less cart = less protection so pain on weight bearing. Muscle atrophy. Imbalance between cart synthesis n degrading.

Question 4

key symptom of osteoarthritis.

Answer 4

morning joint stiffness less than 30mins

Question 5

Radiographic changes in osteoarthritis?

Answer 5

Sclerotic bone, subchondral cysts, osteophytes, narrowing joint spaces

Question 6

drugs for osteoarthritis

Answer 6

analgesics, NSAIDs, cox2 inhibitors, steroid injections, hyaluronan(hyalauronic acid) injections

Question 7

difference between rheumatoid and osteoarthritis.

Answer 7

rheumatoid arthritis is usually more deforming and inflaming than osteoarthritis

Question 8

name the KEY feature of rheumatoid arthritis

Answer 8

symmetrical !!! more than 60mins morning stiffness, RF, onset - genetic/environmental? - HLA DR4,

Question 9

what Is present in the blood (raised) in RA pts?

Answer 9

erythrocyte sedimentation rate, CRP, anti-cyclic citrulluniated peptide

Question 10

drugs - management of RA?

Answer 10

NSAIDS, DMARDs (lots of examples in lecture) - reduce symp n prevent further joint damage, painkillers - surgery is less likely as its a multi system disease

Question 11

what combination treatment is used for RA?

Answer 11

Methotrexate/sulphasalazine/hydroxychloroqiuine or methotrexate/lefluomide

Question 12

what is the profix of anti TNF drug?

Answer 12

mab

Question 13

ANTI TNF NEED FULL BLOOD COUNT TO SEE IF THEY ARE FIT FOR TREATMENT

Answer 13

MORE DRUGS IN LECTURE

Question 14

other than the spine, what other systems are effected in ankylosing spondylitis?

Answer 14

eyes, lungs, anaemia, aortic valve disease (bamboo spine - joint spaces calcify)

Question 15

When does ankylosing spondylitis onset?

Answer 15

Teens - early twenties

Question 16

what is the link between psoriasis and arthritis?

Answer 16

most people with psoriasis don’t have arthritis but it is more common in those with nail lesions, rheumatoid factor is usually negative

Question 17

what is arthrodesis

Answer 17

when joint is fused in a position of function

Question 18

when does the onset of reactive arthritis peak?

Answer 18

onset peaks 10-14days after distant infection, could be due to GI (campylobacter, salmonella, urogenital (chlamydia)), causative infection often not found

Question 19

what is reiters syndrome

Answer 19

reactive arthritis plus conjunctivitis or urethritis

Question 20

reiters syndrome tx ?

Answer 20

self limiting, NSAIDs, DMARD therapy

Question 21

what antibodies is sjrogens associated with

Answer 21

anti-ro (ss-A) and anti-LA (SS-B), patients at higher risk of lymphoma due to lymphocytic infil of lacrimal/salivary glands.

Question 22

Clinical features - sjrogens

Answer 22

tired, dry mouth n eyes, arthritis, raynauds, interstitial lung disease, renal tubular acidosis. chronic n incurable!!!- only given steroids for severe systemic issues.

Question 23

which type of arthritis is mechanical?

Answer 23

osteoarthritis

Question 24

name 3 connective tissue diseases?

Answer 24

SLE, sjrogens, scleroderma