Brainscape's Knowledge GenomeTM

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


See full index

Rheumatology and orthopaedics > Pathology > Flashcards

Pathology Flashcards

1
Q

Osteomyelitis?

A

Cx - Infection of the bone - Bacteria in blood such as staph aureus, trauma or surgery

Sx - Inflammation, swelling, hot, loss of function in the joint bone

SPx - Humerus or femur in children and vertebral bones in adults

Ix - Blood tests, aspirates, MRI or CT of tissue

Mx - Remove dead tissue, aspirate fluid from joint, Initial IV antibiotics then prescribed - ceftriaxone and/or penicillin antibiotics

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

Osteomalacia?

A

Cx - Softening of bones by Vit D deficiency that means calcium levels are reduced

Sx -Often none > fatigue, bone pain, muscle weakness and aches, anorexia?

SPx - Dark skin pigmentation needs longer in sun to produce same amount of vitamin D, stomach surgeries, kidney or liver disease, coeliac

Mx - Vitamin D supplements

Ix - Reduced Ca and PO, ^PTH, ^alkaline phosphate

*Leads to 2nd hyperPT

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

Rickets

A
  • Osteomalacia in kids
  • Effects epiphyseal growth plate that hasn’t closed leading to softening and leaking of bones

Sx - Leads to delayed growth, motor skills, pain in pelvis and spine, swollen wrists - due to excessive non mineralised osteoid at growth plate

Ix - Low Ca

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

Padget’s bone disease

A

Cx - Over active osteoblast and osteoclast

Sx - Bone deformities and pain with areas of varying bone density

Mx - Bisphosphates (knock out osteoclasts)

Ix - Normal Ca and PO, ^^alkaline phosphate, normal PTH

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

Osteoarthritis

A

Cx - Wear and tear type that occurs in synovial joints

Sx - Joint pain, stiffness, weakness, worsened by activity,
** loss of joint space, osteophytes (margins of joint), subchondral sclerosis (increased bone density), subchondral cysts,

  • Herberns nodes - DIP swelling
  • Bouchard nodes - PIP swelling

SPx - Made worse by activity, hands, knees, hips and spine and NO systemic upset, more likely in females

Mx - topical NSAIDs 1st
- oral NSAID with PPI
- steroid injections

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

Rheumatoid arthritis

A

Cx - Auto immune - IgM antibodies attack IgG antibodies

Sx - chronic inflammation in the joint lining, tendon sheath and bursa, swelling, pain and stiffness

SPx - Tends to be symmetrical, more likely in women, often in hands, fingers, feet, ankle, systemic upset, worse in the morning, cholesterol deposits in nodules
*DIP spared

Mx - DMARDs - methotrexate
- Steroids for flares
Anti TNF

Ix - Elevated rheumatic factor, anti CCP antibodies**, CRP and ESR
- x rays of affected joints showing loss of joint space
- Joint aspirate - high WCC, yellow fluid, no crystals,

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

Gout

A

Cx - Deposits of uric acid (needle shaped) - negative bifrinegent crystals/monosodium urate in the synovial of joints

Sx - Swollen, hot, painful joints

SPx - More likely if you’re male, consume alcohol, high purine diet, cardiovascular disease, typically base of big toe, thumb and wrist

Mx - NSAID’s, steroids and prophylaxis
- oral colchicine (alternative in acute attacks)
- Allopurinol long term for reducing serum urate (NSAID or diclofenac should be given along side)

Ix - Raised blood uric acid levels, aspirates, x ray off joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Osteoporosis

A
  • Reduced bone density leading to increased fracture risk
  • Bone and muscle pain/weakness, back pain caused by collapsed vertebrae
  • More likely in females, post menopausal, early menopause, long term steroids

Mx- bisphosphates - Alendronic acid and risedronate, denosumab -monoclonal antibody that regulates osteoclasts, teriparatide - synthetic PTH

Ix - DEXA scan used to determine bone density, bloods - Ca, PO, ALP, PTH normal
- T score for young individuals of same sex
- Z score for individuals of same age and sex

** Frax tool for assessing individual risk

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

Curare paralysis

A
  • Competitive antagonist of nicotinic cholinergic receptors causing paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Botox toxins

A
  • Inhibit exocytosis, Ach unable to cross synaptic cleft and bind in junctional folds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Carpal tunnel syndrome

A

Cx - Compression on the median nerve caused by inflammation

Sx - Tingling, numbness or pain in 3.5 digits (thumb, index, middle and half of ring)

Mx - Cut flexor retinaculum to release pressure, steroid injection to relive inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rigor mortis

A
  • Where after an AP has occurred and no ATP is synthesised, can’t break the cross bridge between actin and myosin
  • Muscles become rigid 4 hrs after death around the limbs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Psoriasis

A
  • Too many keratinocytes

Sx - itching and patchy skin, red and pink dry skin with slivery/white scales

Ix - Skin biopsy

Mx - topical steroids (creams and ointments)

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

Ankylosing spondylitis

A

*Typically in a young man with lower back pain worse in the mornings and night
* Associated with HLA B27 gene

  • Inflammatory condition causing progressive stiffness and pain

Cx - inflammation in lower axial skeleton
- sacroiliac joints and vertebral column

Sx - lower back pain that radiates to the bum, often stiffness or pain in the mornings, can be woken at night, better on exercise , swimming helps
- restrictive lung defect

Ix - CRP and ESR
* - HLA B27 genetic test
* - X ray of sacroiliac joints
- MRI of spine to show bone marrow oedema

Mx - NSAIDS and exercise regime first line
- steroids
- additional physio

*more common in men

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

Marfan’s syndrome

A
  • A dominant inherited disorder that affects CT
  • commonly affecting heart, eyes, blood vessels and skeleton
  • Can affect the aorta causing dissections and aneurysm that can be life threatening

Cx - mutation in fibrillar 1 protein

Sx - tall and slender builds
- high arched palate and crowded teeth
- heart murmurs
- extreme near sightedness
- flat feet and a curved spine
- protruding or sunken breast bone

Ix - genetic testing

*Recurrent pneumothoraces common

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

Psoriatic arthritis

A

*Inflammatory arthritis associated with psoriasis
- asymmetrical

Sx - plaques of psoriasis on the skin
- pitting of the nails
- oncholysis
- dactalysis
**Eye disease, aortitis, amyloidosis
- worse in mornings, improves with use
***Affects hands and feet

Ix - PEST screening tool -those with psoriasis
X ray - periostitis, ankylosis, osteolysis, dactylitis,

Mx - NSAIDS
- Methotrexate
- Anti TNF meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Reactive arthritis

A
  • Where synovitis occurs as a reaction to a recent tigger - can affect multiple joints and can take 4 weeks post infection
  • often single joint in lower limb (knee)
    **no infection in the joint

Cx - gastroenteritis, chlamydia (STI),

Axs - bilateral conjunctivtis, anterior uveitis, circinate balanitis
**(can’t see, pee or climb and tree)

Sx - hot, swollen, painful joint

Ix - ESR, CRP, ANA, rheumatoid factor
- no infection in the joint itself

Mx (when septic arthritis is excluded)
- NSAID
- steroid injections
- recurrent cases may rewire DMARDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lupus erythematosus

A

*Inflammatory autoimmune CT disease
*More common in women and Asias around middle age
*systemic so affects multiple organs
** Can be drug induced by hydrazine

Sx - non specific symptoms
- fatigue, weightloss, joint and muscle pain, fever, photosensitive malaria rash (across face), mouth ulcers, SOB, raynauds, hair loss, clots

Ix - Anti nuclear antibodies (99%)
- anti double stranded DNA antibodies (most specific to SLE)
- CRP and ESR riased
- protein uria for lupus nephritis
- C3 and C4 reduced - auto immune acute disease
- lupus anticoagulant and anti phospholipid antibodies (increase clotting risk)

Mx
- steroids
- hydroxycloroquine - treatment of choice 1st
- Azithroprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sciatica

A

Cx - L5-S1 disc herniation compressing spine

Sx - Pain, numbness, tingling, weakness of glutes, bad, of legs, calves, foot and toes, possible urinary incontinence
***Unilateral

Ix - MRI
- positive leg raise test

Mx - Usually heals on its own,
- NSAIDS and steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cauda equina

A

Cx - Ruptured disc, stenosis, tumour….

Sx - Faecal and urinary incontinence
- reduced power in limbs
- reduced sensation to pain and temperature
***Bilateral symptoms

  • Urinary incontinence a late symptom

Ix - MRI

Mx - surgical decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pseudogout

A
  • Older adult with hot, swollen, painful knee
  • Haemachomatosis a RF

Cx - depositis of calcium pyrophosphate crystals

Sx - typically milder presentation than gout and septic arthritis

Ix - exclude septic arthritis
- Aspirate joint fluid showing: no bacterial growth, calcium pyrophosphate crystals, rhomboid shaped crystals, positive infringement of polarised light
- chonedrocalcinosis (thin white line in middle of joint due to calcium deposition) (LOSS)

Mx - aspirate to exclude septic arthritis
- NSAIDS, steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adhesive capsulitis

A

*Also known as frozen shoulder

Sx - problems with active and passive movements
- last 6months -2years

Mx - NSAID, physio, roads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Compartment syndrome

A
  • Complication that may occur following surgery or ischaemia reperfusion
  • Raised pressure in a compartment compromises tissue perfusion, leading to necrosis
  • Most common in supracondylar humerus and tibial shaft fractures

Sx - pain especially on movement
- parasthesia
- pallor
- pulse may still be felt
- Paralysis of muscles

Ix - pressure in compartment above 4ommHg

Mx - fasiotomy

24
Q

Cubital tunnel syndrome

A

*Ulna nerve is compressed inside the cubital tunnel

Cx - person bends elbow, lifting, reaching and pulling motions
- arthritis, previous fractures

Sx - funny bone pain, numbness in ring or little finger, weak grip, drops things, claw hand

Mx - NSAIDs and steroids

25
Q

Giant cell arteritis/ temporal arteritis

A

Vasculitis of medium and large arteries - typically temporal arteries
* Associated with poly myalgia rheumatica

  • Higher risk if white females over 50

Sx - Severe unilateral headache around temporal area, scalp tenderness, jaw claudication, blurred or double vision, painless sight loss
- Other common systemic features

Ix - giant cells found on temporal artery biopsy, ESR raised, CRP raised
- reduced Hb, thrombocytosis,

Mx - first line high dose pred
- if evolving vision loss - IV methylpred

26
Q

Fibromyalgia

A
  • Widespread pain in Body most common around 30-50
  • 5x more common in women

Cx - Unknown

Sx - widespread pain at multiple sites or all over
- cognitive impairment
- lethargy
- sleep disturbance and headaches

Mx - aerobic exercise
Antidepressants - duloxetine…

27
Q

polymyalgia rheumatica

A
  • Usually affects Asian women more often
  • Associated with giant cell arteritis
  • Older adults affected

Cx -

Sx - pain and stiffness in neck, arms, shoulders and pelvic girdle but can be everywhere, affects sleep, worse in the morning, worse when moving, weight loss and fever - rapid onset

Ix - ESR raised CRP raised, CK normal,

Mx - Prednisolone 15mg - should respond quick
- Anti TNF when failure to respond

28
Q

Sjögren’s syndrome

A
  • Autoimmune condition affecting exocrine glands causing dryness and itching
  • Much more common in females

Cx - autoimmune

Sx - dry eyes and mouth, vaginal dryness, joint pain, raynauds,

Ix - RF positive, ANA,
**anti Ro, anti La
* SCHIRMERS TEST
- lymphocytic infiltration on histology - lymphoid malignancy risk

Mx - Immune suppression - hydroxychloroquin
- cyclosporin for dry eyes
- pilocarpine for dry mouth
-

29
Q

Septic arthritis

A
  • Haematgenous spread most common

Cx * staph aureus
* unless sickle cell anaemia =salmonella
* Adults sexually active =neisseria gonorrhoea (gram negative diplococci)
- direct penetration or surface infection, surgery
* Can spread from a distal infection point via blood

Sx - Acutely pain, hot, swollen joint (most common at knee)
- problems with function, fever, hot joint

Ix - Synovial fluid sampling
- x ray, blood cultures

Mx - IV antibiotics - flucloxacilin or clydamycin if penicillin allergy
- needle aspiration for decompression

30
Q

Raynauds

A

Cx - Vasospasm of smaller arteries that supply fingers
Cx - disease of arteries, CT disease, disease of arteries, smoking

Sx - cold fingers or toes, skin turn white the blue, numb tingly feeling or pain upon warming or stress relief

Ix - ANA, ESR

Mx - CCB - nifedipine - rapid onset
- vasodilators

31
Q

Paracetamol overdose

A

Sx - abdominal pain, nausea, yellowing of skin and eyes, headache, confusion or drowsiness

Mx - IV N-acetylcysteine
- activated charcoal if <4hrs
Vit K if INR/PT increased

  • check levels 4-15hrs after (don’t give treatment too early - treatment line)
32
Q

Tricyclic antidepressant overdose

A

Sx - Dilated pupils and tachycardia, seizures, arrhythmia (QRS>100ms)

Mx - activated charcoal<1hr
- benzodiazepines for seizures
- IV Na bicarb

33
Q

Aspirin overdose

A

Sx - tachypneoic and tachycardia
- pulmonary oedema
- sweating, tinnitus**, bleeding, drowsiness,

Mx - Na bicarb for acid (aspirin is an acid)
- activated charcoal
- correct electrolytes

34
Q

Beta blockers overdose

A

Sx - bradycardia, confusion, hypotension

Mx - IV atropine, IV glucagon, pacing if not responsive

35
Q

Opioid overdose

A

Sx - Pin point pupils, reduced rest, reduced GCS, rest acidosis

Mx - IV naloxone

36
Q

Digoxin overdose

A

Sx - yellow halls, hypotension, drowsiness, nausea, anorexia

Mx - IV digibind
- treat hypokalaemia

37
Q

Benzodiazepines overdose

A

Sx - drowsiness, dilated pupils, reduced resp rate

Mx - flumazemil

38
Q

Iron overdose

A

Sx - GI and liver problems

Mx - gastric lavage
- IV Deferoxamine

39
Q
  • Haemarthrosis
A

*Bleeding into the joint space (most commonly knee)

Cx - Aneursym, trauma, haemophilia, arthritis, vit K deficiency, ligament tears

Sx - pain, swelling and inflammation, trouble moving, bruising, hot joint

Ix - X ray, arthrocentesis,

Mx - pain and swelling

40
Q

Antiphospholipid syndrome

A
  • 30% have SLE

Sx - recurrent thromboses

Ix - anti cardiolipin, anti beta 2 glycoprotein, lupus anti coag, thrombocytopenia, prolonged APTT

Mx - aspirin
- lifelong warfarin

41
Q

Osteogenesis imperfecta

A

*Brittles bone disease

Cx - Autosomal dominant, abnormality in type 1 collagen

Sx - multiple bone fractures, blue sclera, deafness due to otosclerosis, dental imperfections

Ix - Ca, Po, ALP, PTH all normal

42
Q

Still’s disease

A

Sx - joint pain, rash (salmon pink or macropapular), pyrexia, lymphadenopathy, raised ferritin and leukocytes

  • Diagnosis of exclusion - RF and ANA negative

Mx - NSAIDs

43
Q

Discoid lupus

A
  • Auto immune chronic skin condition, more common in women between 20-50
  • Dark skin patients
  • Increase risk of SLE

Px - lesion on scalp, face and ears
- Photosensitive
- Axs with scarring alopecia
-

Ix - skin biopsy

Mx - sun protection
steroids

44
Q

Systemic sclerosis

A
  • Auto immune CT disease involving inflammation and fibrosis of CT and organs

Cx - unknown

Limited cutaneous/crest syndrome - Calcinosis, raynauds phenomenon, oesophageal dismotility, sclerodactaly, Telangiectasis

Ix - ANA and Anti centromere

Diffuse cutaneous - Includes CREST^ plus: CV, resp and kidney problems

Ix - ANA, anti Scl-70

Mx - DMARDs and biologics in diffuse

45
Q

Polymyositis

A
  • Autoimmune condition causing muscle inflammation and proximal muscle weakness

Sx - Gradual onset, symmetrical, proximal muscle weakness
- difficulties standing, overhead pressing, walking up stairs
- muscle pain can sometimes be present

Ix - CK elevated, Anti Jo 1,

Mx - steroids first line

  • can be due to paraneoplastic
46
Q

Dermatomyositis

A

^ Polymyositis plus skin changes

Sx - Gottron papules (back of hands) and heliotrope rash on eye lids, periorbital oedema, photosensitive rash on torso

Ix - CK elevated, Anti Jo 1

Mx - Steroids

  • CaN be paraneoplastic
47
Q

Small vessel vasculitis

A
  • Henoch-Schonlein Purpura
  • Microscopic Polyangiitis (ANCA)
  • Granulomatosis with Polyangiitis (ANCA)
  • Eosinophilic Granulomatosis with Polyangiitis (ANCA)
48
Q

Medium vessels vasculitis

A
  • Polyarteritis Nodosa
  • Kawasaki Disease
49
Q

Large cell vasculitis

A
  • Giant Cell arteritis
  • Takayasu’s Arteritis
50
Q

Henoch-Schonlein Purpura

A
  • IgA nephritis - affects kids u10 - IgA deposits In vessels

Px - lower leg and buttocks purport rash
- joint pain, abdo pain, renal involvement

Mx - conservative
- analgesia, rest and good hydration
* Steroids for kindneys

51
Q

Microscopic Polyangiitis (ANCA)

A
  • Small vessels vasculitis

Px - Renal failure due to glomerulonephritis
- Hameoptysis

Ix - P-ANCA positive - MPO
- can be C- ANCA - PR3

Mx - steroids

52
Q

Granulomatosis with Polyangitis

A
  • Small vessel vasculitis

Px - affects resp tract
- nose bleeds, hearing loss, sinusitis
- wheeze, haemoptysis
* SADDLE SHPAED NOSE - nasal bridge collapse
- rapidly progressing glomerulonephritis

Ix - C-ANCA positive

Mx - Steroids

53
Q

Eosinophilic Granulomatosis with Polyangitis

A
  • Small vessel vasculitis
  • Primarily affects lungs and the skin

Px - Severe asthma
- sinusitis, allergic rhinitis
- can affect kidneys

Ix - eosinophilia, P-ANCA positive

Mx - steroids

54
Q

Behcets disease

A
  • Inflammatory condition of vessels causing recurrent oral and genital ulcers
  • can affect multiple organs

Px - oral ulcers 3x per year - painful, red halo, sharp borders
- genital ulcers the same
- heal in 2-4 weeks and may leave scars

Ix - Pathergy test - needle to skin
- HLA B51 gene

Mx - Topical and oral steroids
- …

55
Q

Ehlers-danlos syndrome

A
  • Group of genetic conditions involving collagen defects

Px - hyper mobility In joints and abnormalities in CT

Ix - Beighton score for hypermobilty

56
Q

Perthe’s Disease

A
  • Childhood condition where too little blood gets to the femoral head and bone begins to die
    RF - age 4-10 and male

Cx - unknown

Sx - Limping, pain, stiffness, worse with activity, limited range of motion

Ix - X ray - may not show changes initially
- shows increased joint space and loss of smooth shape of femoral head

Mx - Surgery

Rheumatology and orthopaedics (4 decks)

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