Brainscape's Knowledge GenomeTM

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


See full index

Musculoskeletal > Rheumatology: Osteoarthritis, Crystal Arthropathies, Soft tissue Rheumatism > Flashcards

Rheumatology: Osteoarthritis, Crystal Arthropathies, Soft tissue Rheumatism Flashcards

1
Q

What is Osteoarthritis typically described as?

A

“wear and tear” of the joints

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

What are the risk factors for developing osteoarthritis?

A

Age, muscle weakness, occupation, genetic elements, sports, previous injuries

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

What is the link between osteoarthritis and osteoporosis?

A

Can’t have both, osteoporosis protects against osteoarthritis

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

What can be seen on an osteoarthritis X-ray?

A 
LOSS
Loss of joint space
Oesteophytes
Sclerosis
Subchondral cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are osteophytes?

A

Bone spurs with jagged edges

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

What happens in subchondral cysts?

A

Synovial fluid flows into breaks in the cartilage

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

What are factors which contribute to development of osteoarthritis?

A

Complex interplay of many factors: genetic, joint integrity, mechanical force and cellular and biochemical forces

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

Who is commonly affected by osteoarthritis?

A

1/3rd of population over age of 45, 1/2 population over 70

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

What are the different types of osteoarthritis?

A

Idiopathic or Secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can Idiopathic osteoarthritis be further divided into?

A

Localised (1 site) or generalised (3 or more sites)

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

What can cause secondary osteoarthritis?

A

Previous injury, genetic elements, rheumatoid arthritis, agromegally, calcium crystal deposition

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

What is the typical clinical presentation of osteoarthritis?

A

Pain, worse of activity and relieved by rest

Stiffness in morning lasting

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

What can be seen on examination is osteoarthritis?

A

Crepitus, swelling (bony enlargements due to osteophytes), Heberden’s nodes and Bouchard’s nodes

Later stages: joint tenderness and effusion

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

What joints can be affected by osteoarthritis?

A

All weight baring joints of lower limb: hip, knee, ankle, tarsal, metatarsals
Hands, arms and spine

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

What clinical features can be seen on the knee in osteoarthritis?

A

Baker’s cyst, gene varus, gene valgus

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

What is gene varus and what is it seen as clinically?

A

Knee moving towards the midline, seen as bow legged clinically

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

What is gene valgus and what is it seen as clinically?

A

Knee moving away from the midline, seen as knock-kneed clinically

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

What can be seen on the hands on examination in osteoarthritis?

A

Bouchard’s nodes and Heberden’s nodes and squaring of the thumbs

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

How is the spine affected in osteoarthritis?

A
  • Mainly facet joints affected
  • Osteophytes may compress the nerve roots
  • Cervical area affected causes restriction of movement and pain
  • Osteophytes at lumbar region can cause spinal stenosis, and if encroaches on spinal canal can cause problems with walking, spinal claudication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can hip pain be felt in osteoarthritis?

A

As pain radiating to the knee or groin

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

What is the natural history of progression of osteoarthritis in the hands?

A

Over a 2 year period, pain often improves although swelling becomes more marked

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

What is the natural history of progression of osteoarthritis in the knee?

A

1/3 of patients’ symptoms improve, 1/3 are stable and 1/3 deteriorate

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

What is the natural history of progression of osteoarthritis in the hip?

A

10% come off the surgical waiting list as symptoms improve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the non pharmacological interventions in osteoarthritis?

A

Explanation, physiotherapy and “common sense measures” such as weight loss, walking stick and exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the surgical interventions in osteoarthritis?

A
  • Best treatment is joint replacement if there are no other co-morbidities
  • Arthroscopic washout is plan B which involves soft tissue trimming
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the pharmacological interventions in osteoarthritis?

A
  • Analgesia eg ibuprofen, paracetomol for pain
  • NSAIDs
  • Temporary solution: inject steroid into joints
27
Q

When should NSAIDs be avoided?

A
  • In patients with renal impairment
  • Angina
  • Increased risk of peptic ulcer disease
28
Q

What grading scale is used to chart osteoarthritis?

A

Kellegren-Lawrence Radiographic Grading Scale, grades 0-4

29
Q

What is gout?

A

Inflammation of the join triggered by uric acid crystals

30
Q

At what level does uric acid become insoluble?

A

> 0.42mmol

31
Q

What causes the imbalance of uric acid production?

A
  • Excess consumption
  • Over production
  • Under excretion
32
Q

What factors can cause decreased urate excretion?

A

Hypothyroidism, cytotoxics, volume depletion by heart failure, Thiazide diuretics, chronic renal impairment

33
Q

What factors can cause increased urate production?

A

inherited enzyme defects, psoriasis, haemolytic disorder, alcohol, high dietary intake

34
Q

Who is commonly affected by gout?

A
  • Rare before the age of menopause

- Obesity and adverse dietary factors increase risk

35
Q

Where is the most commonly affected areas in acute gout?

A

Most common= big toe followed by ankle and knee

36
Q

How long does it take for acute gout to settle?

A

About 3 days with treatment and 10 days without

37
Q

How does acute gout present?

A

Abruptly, often overnight

38
Q

How will uric acid level be at acute presentation of gout?

A

Probably normal

39
Q

What drug is chronic gout often associated with?

A

Diuretics

40
Q

What constitutes chronic gout?

A

More than 4 joints affected at one given time

41
Q

What are the investigations for gout?

A
  • 10% of people have high uric acid level
  • Raised inflammatory markers
  • Polarising microscopy of synovial fluid
  • x ray
42
Q

What should you look for in an X-ray of gout?

A

Dense shadow which extends across the joint

43
Q

What is the treatment of acute gout?

A

1 of the following:

  • NSAIDs
  • Colchicine
  • Steriods
44
Q

What is the prophylaxis of gout?

A

-Allopurinol or Febuxostat

45
Q

How long should you wait after an acute attack of gout before prescribing prophylaxis?

A

2-4 weeks

46
Q

What does Chronic Tophaceous Gout present as?

A

Hard nodular mass

47
Q

What is pseudo gout?

A

Increased calcium pyrophosphate crystals

48
Q

Who does pseudo gout typically affect?

A

The elderly

49
Q

Why does pseudo gout affect the elderly?

A

Chondrocalcinousis increases with age

50
Q

What does pseudo gout affect?

A

The fibrocartilage, most commonly the knees and wrists

51
Q

How is pseudo gout diagnosed?

A

By polymicroscopy

52
Q

What is the treatment for pseudo gout?

A

Similar to gout: NSAIDs, colchicine, steriods, rehydration

53
Q

Who does joint hyper mobility syndrome typically affect and who does it arise?

A

females in childhood or in 30s, can be caused by rare genetic syndrome such as Marfan’s or Ehler’s

54
Q

What is soft tissue rheumatism?

A

General term used to describe pain that is caused by inflammation/damage to ligaments, tendons, muscles or nerves near a joint rather than the actual bone or cartilage

55
Q

How does soft tissue rheumatism typically present?

A

Localised to one side e.g. shoulder, wrist

56
Q

Give examples of soft tissue rheumatism of the foot, wrist, elbow..

A

Foot= plantar fasciitis
Wrist= carpal tunnel
Elbow: Cubital tunnel

57
Q

Where is the most commonly affected area in soft tissue rheumatism?

A

Shoulder and neck

58
Q

What is Hydroxyapatile?

A

Deposition of hydroxyapatite crystals in or around the joint

59
Q

What is “Milwankee shoulder”?

A

Another name for Hydroxyapatile which is deposition of hydroxyapatite crystals in or around the joint

60
Q

Who does Hydroxyapatile most commonly affect?

A

Females 50-60yrs

61
Q

What is the treatment for Hydroxyapatile?

A

NSAIDs, intra-articular steriod injection, physiotherapy

62
Q

How does Hydroxyapatile arise?

A

Deposition of hydroxyapatite crystals in or around the joint causes the release of collagenases, serine proteinases and Il-1 which causes acute and rapid decline in joint function and degradation of joint anatomy

63
Q

What is the onset of symptoms of Hydroxyapatile?

A

Acute and rapid deterioration

Musculoskeletal (13 decks)

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