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phase2a medicine > musculoskeletal (non-inflammatory) > Flashcards

musculoskeletal (non-inflammatory) Flashcards

Information regarding diseases the affect the musculoskeletal system. Largely excluding inflammatory conditions (see Musculoskeletal inflammatory deck for more information).

1
Q

definition of osteoporosis

A

a systemic skeletal disease characterised by low bone mass and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture

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2
Q

risk factors for osteoporosis

A 
age
parental history
untreated menopause
prolonged immobility
BMI <19
rheumatoid arthritis
>4 units alcohol/day
reduced skeletal loading
inflammatory disease
endocrine disease
smoking
previous fracture
medication
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3
Q

why does ageing increase risk of osteoporosis?

A

decrease in trabecular thickness

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4
Q

pathology of osteoporosis

A

loss of trabecular bone, crush fractures of vertebrae, loss of cortical bone (causing long bone fractures)

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5
Q

medications that cause osteoporosis

A

glucocorticoids
aromatase inhibitors
GnRH analogues
androgen deprivation

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6
Q

signs of osteoporosis

A

chronic pain
osteoporotic fractures
radicular pain (due to compression of spinal cord)

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7
Q

how many patients die within the first year of having a hip fracture?

A

20%

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8
Q

how do the results of a DEXA scan work for patients with osteoporosis?

A

they are given a T score, which is the standard deviation compared to average peak bone mass

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9
Q

primary causes of osteoporosis

A

menopause
old age
juvenile idiopathic

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10
Q

secondary causes of osteoporosis

A

drugs
smoking
alcohol

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11
Q

treatments of osteoporosis

A 
weight bearing exercise
balance exercise
calcium and vitamin D rich diet
bisphosphonates
HRT
calcitonin
testosterone for men
denosumab (anti-resorptive treatment)
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12
Q

how do bisphosphonates work in the treatment of osteoporosis?

A

stop osteoclasts working

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13
Q

how does denusomab work in the treatment of osteoporosis?

A

stops RANKL from activating osteoclasts so bone is not resorbed
it is a monoclonal antibody

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14
Q

what does a T score of less than -2.5 indicate?

A

osteoporosis

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15
Q

what does a T score of -1 indicate?

A

osteopenia

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16
Q

risk factors for mechanical lower back pain

A

poor posture
repetitive and fast work
heavy manual handling

17
Q

what percentage of people recover from an acute attack of mechanical lower back pain within 6 weeks?

A

90%

18
Q

risk factors for osteomalacia and rickets

A

vitamin D deficiency
anticonvulsant therapy
cancer
liver disease

19
Q

what is rickets?

A

the result of osteomalacia during a period of bone growth

osteomalacia is if it is after fusion of growth plates

20
Q

pathology of osteomalacia/rickets

A

mineral content of bone low

excess uncalcified osteoid and cartilage

21
Q

signs of osteomalacia/rickets

A

femoral neck fractures

22
Q

symptoms of osteomalacia/rickets

A

bone pain and tenderness

Proximal myopathy due to decrease in PO4 and vitamin D deficiency

23
Q

diagnosis of osteomalacia/rickets from plasma

A

severe calcium depletion
increased phosphate ions
increased ALP (alkaline phosphatase)
decreased vitamin D

24
Q

diagnosis of osteomalacia/rickets from biopsy

A

incomplete mineralisation

normal muscle

25
Q

diagnosis of osteomalacia/rickets from XR

A

loss of cortical bone

partial fractures

26
Q

treatment of osteomalacia/rickets

A

vitamin D

monitor plasma calcium

27
Q

risk factors for vertebral disc degeneration

A

poor posture
repetitive and fast work
heavy manual handling

28
Q

symptoms of vertebral disc degeneration

A

chronic back pain
radiating pain
tingling sensation in legs/arms
pain often worse when sitting

29
Q

XR/MRI features of vertebral disc degeneration

A 
black discs
disc space narrowing
vacuum disc
end plate sclerosis
osteophyte formation
30
Q

features of vertebral disc degeneration on clinical examination

A

muscular weakness

limitations in motion

31
Q

treatment for vertical disc degeneration

A 
physical therapy
NSAIDs
traction 
epidural steroid injection 
surgery
32
Q

risk factors for Paget’s disease

A

> 40
temperate climate
anglo-saxon

33
Q

pathology of Paget’s disease

A

increased osteoblasts and osteoclasts –> extensive turnover –> extensive remodelling –> bony enlargement, deformity, and weakness

34
Q

where does Paget’s disease typically affect?

A

axial skeleton

lumbar spine

35
Q

symptoms of Paget’s disease

A

asymptomatic in 70%
deep boring pain
bony deformity
enlargement

36
Q

complications of Paget’s diesase

A

spine pathological fractures
osteoarthritis
increased risk of osteosarcoma

37
Q

XR signs of Paget’s disease

A 
localised bone enlargement
patchy cortical thickening
sclerosis
osteolysis 
deformity
38
Q

blood test results for Paget’s disease

A

calcium and phosphate normal

ALP (alkaline phosphatase) raised

39
Q

treatment of Paget’s disease

A

analgesia

alendronic acid

phase2a medicine (53 decks)

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