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Year 5 Histopath > Non-neoplastic Bone Disease > Flashcards

Non-neoplastic Bone Disease Flashcards

1
Q

Define Gout:

A

a rheumatic disease resulting from deposition of uric acid crystals ( monosodium urate) in tissues and fluids within the body.

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2
Q

Define pseudogout:

A

a form of arthritis characterized by sudden, painful swelling in one or more of your joints.

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3
Q

What is the main difference between gout and pseudogout?

A

Pseudogout is caused by calcium pyrophosphate dihydrate (CPPD) crystals, and gout is caused by sodium urate crystals.

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4
Q

Who is affected by gout?

A

Middle aged men]

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5
Q

Who is affected by pseudogout?

A

> 50 years

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6
Q

Which joints are commonly affected in Gout?

A

Big toe - MTP (podagra)
Lower extremities e.g. kneeBig toe - MTP (podagra)
Lower extremities e.g. kneeBig toe - MTP (podagra)
Lower extremities e.g. knee

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7
Q

Which joints are commonly affected in pseudoGout?

A

Knee
ShoulderKnee
ShoulderKnee
Shoulder

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8
Q

What can cause gout?

A

Increased dietary purine intake (dairy + protein)
ETOH
Diuretics
inherited metabolic abnormalitiesIncreased dietary purine intake (dairy + protein)
ETOH
Diuretics
inherited metabolic abnormalitiesIncreased dietary purine intake (dairy + protein)
ETOH
Diuretics
inherited metabolic abnormalities

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9
Q

What can cause pseduogout?

A 
Idiopathic
HyperPTH
DM
Hypothyroid
WilsonsIdiopathic
HyperPTH
DM
Hypothyroid
WilsonsIdiopathic
HyperPTH
DM
Hypothyroid
Wilsons
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10
Q

Clinical features of pseudogout?

A

Hot swollen joint with effusion

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11
Q

Clincial features of gout?

A

Swollen
red
Exquisitely painful joint
Tophus (s/c deposits of urate) is the pathognomonic lesion e.g. on pinna and handsSwollen
red
Exquisitely painful joint
Tophus (s/c deposits of urate) is the pathognomonic lesion e.g. on pinna and handsSwollen
red
Exquisitely painful joint
Tophus (s/c deposits of urate) is the pathognomonic lesion e.g. on pinna and hands

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12
Q

Describe and name the crystal in gout?

A

Urate crystals
Needle shapeUrate crystals
Needle shapeUrate crystals
Needle shape

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13
Q

Describe and name the crystal in pseudogout?

A

Calcium pyrophosphate crystals
Rhomboid shapedCalcium pyrophosphate crystals
Rhomboid shapedCalcium pyrophosphate crystals
Rhomboid shaped

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14
Q

What investigations diagnose gout?

A

Negatively birefringent crystals

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15
Q

What investigations diagnose pseudogout?

A 
Positively birefringent 
(P for positive and pseudo)Positively birefringent 
(P for positive and pseudo)Positively birefringent 
(P for positive and pseudo)
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16
Q

What is the management of acute gout?

A

Colchicine

17
Q

What is the management of long term gout?

A

Allopurinol

Conservative: lower ETOH and purine intake e.g. sardines and liverAllopurinol

Conservative: lower ETOH and purine intake e.g. sardines and liver

18
Q

What is the management of pseudogout?

A

NSAIDs or intra-articular steroids

19
Q

What are the 5 different types of fracture?

A 
Simple
Compound
Greenstick
Comminuted
ImpactedSimple
Compound
Greenstick
Comminuted
Impacted
20
Q

What is the healing process of a fracture?

A

1) Organisation of haematoma (pro-callus)
2) Formation of fibrocartilaginous callus
3) Mineralisation of fibrocartilaginous callus
4) Remodelling of bone along weight bearing lines1) Organisation of haematoma (pro-callus)
2) Formation of fibrocartilaginous callus
3) Mineralisation of fibrocartilaginous callus
4) Remodelling of bone along weight bearing lines

21
Q

What can influence how a fracture heals?

A 
Fracture type
Metabolic disorder
Drugs
Vitamin deficiency
InfectionFracture type
Metabolic disorder
Drugs
Vitamin deficiency
Infection
22
Q

Define osteoarthritis

A

degeneration of joint cartilage and the underlying bone, most common from middle age onward. It causes pain and stiffness, especially in the hip, knee, and thumb joints.

23
Q

Which joints may you see Heberdens nodes and in what disease?

A

DIP joint - Osteoarthritis

24
Q

Which joints may you see Bouchard’s nodes and in what disease?

A

PIP joint - Osteoarthritis

25
Q

Define ostemyelitis:

A

inflammation of bone or bone marrow, usually due to bacterial infection. Caused by haematogenous spread or local infection e.g. post trauma

26
Q

Which organism causes osteomyelitis in Adults and where does it commonly affect?

A

S. Aureus.
Vertebrae, jaw (2ndary to dental abscess) and toes (2ndary to diabetic skin ulcer)S. Aureus.
Vertebrae, jaw (2ndary to dental abscess) and toes (2ndary to diabetic skin ulcer)

27
Q

Which organism causes osteomyelitis in children and where does it commonly affect?

A

Haemophilus influenza
Group B strep

Long bonesHaemophilus influenza
Group B strep

Long bones

28
Q

How does osteomyelitis present?

A

Pain
swelling
Tenderness

General features of; malaise, fever, chills, leukocytosisPain
swelling
Tenderness

General features of; malaise, fever, chills, leukocytosis

29
Q

What are rare causes of osteomyelitis?

A

TB (immunocompromised patients)
Syphilis (congenital/acquired)TB (immunocompromised patients)
Syphilis (congenital/acquired)

30
Q

What are the X-ray changes in osteomyelitis?

A

Lytic destruction of bone ~10days after onset

31
Q

What is the clinical presentation of rheumatoid arthritis?

A

Symmetrical
Small joints of hands and feet (spares DIPJ), wrists, elbows, ankles and knees
Usually slow progressionSymmetrical
Small joints of hands and feet (spares DIPJ), wrists, elbows, ankles and knees
Usually slow progression

32
Q

Which joints does rheumatoid usually spare?

A

DIP

33
Q

What are the characteristic deformaties of rheumatoid?

A

Z shaped thumb
Swan neck and Boutonniere deformity of fingers
Radial deviation of wrist and ulnar deviation of fingers

Year 5 Histopath (17 decks)

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