Rheumotology

Question 1

What association is RA?

Answer 1

HLADR4

Question 2

Joint pain in RA?

Answer 2

Early morning stiffness/pain >30 mins
EASES with use
sinovial joint inflammation.

Question 3

Joint pain in OA?

Answer 3

less than 30 in early moring. degenerative . worse with use. articular cartilage erosion. non inflammatory pain

Question 4

Signs of RA?

Answer 4

LESS on x-ray
Boitonierre's
swan neck, ulnar deviation, 
z thumb
nodules
rarely affects DIP
symmetrical joints. hot red and swollen

Question 5

Signs of OA?

Answer 5

Herbens (DIP)
Buchards (PIP)
asymmetrical
thumb and big toe, hip and knees.

Question 6

Treatment for RA?

Answer 6

2 x DMARDs (one being Methotrexate).

Analgesia

Question 7

treatment for OA?

Answer 7

Nsaids, paracetamol, surgery replacment of joints,

Question 8

Extra articular manifestations of RA?

Answer 8

NODULES
Carpal tunnel syndrome
Anaemia (chronic disease/autoimm.)
Lungs - caplan’s, nodules
Eyes – sjogren’s, scleritis, episcleritis
Felty’s syndrome

Question 9

What thiazide should be replaced when treating gout?

Answer 9

bendrofluromethiazide should be replaced with cosartan

Question 10

what prevents gout from occuring?

Answer 10

allopurinol (inhibitor of xanthine oxidase)

Question 11

Name two Nsaids. which one is used in gout? which is used in OA?

Answer 11

OA - diclofenac

Gout- colchicine

Question 12

What are synovial bursae?

Answer 12

fluid filled sacs in synovial joints to cushion a joint more

Question 13

Which synovial bursae are important in the shouldeR?

Answer 13

subscapular, subacromial synovial bursae

Question 14

What does the subacromial bursae do?

Answer 14

subacromial bursa reduces friction beneath the deltoid, promoting free motion of the rotator cuff tendons

Question 15

What are the ligaments of the shoulder joint?

Answer 15

glenohumeral (middle, inferior, superior), coracohumeral ligament, transverse humeral, coraco-clavilcular (composed of conoid and trapezoid ligaments)

Question 16

what nerve injury can cause deltoid muscle wasting?

Answer 16

axillary nerve injury

Question 17

what muscles extend shoulder joint?

Answer 17

posterior deltoid, latissimus dorsi and teres major

Question 18

What muscles flex the shoulder joint?

Answer 18

pectoralis major, anterior deltoid and coracobrachialis. Biceps brachii weakly assists in forward flexion

Question 19

Muscles repsonsible for abduction of shoulder joint?

Answer 19

The first 0-15 degrees of abduction is produced by the supraspinatus.
The middle fibres of the deltoid are responsible for the next 15-90 degrees.
Past 90 degrees, the scapula needs to be rotated to achieve abduction – that is carried out by the trapezius and serratus anterior

Question 20

Adduction of shoulder joint muscles?

Answer 20

contraction of pectoralis major, latissimus dorsi and teres major

Question 21

internal roation of shoulder joint?

Answer 21

contraction of subscapularis, pectoralis major, latissimus dorsi, teres major and anterior deltoid

Question 22

external rotation of shoulder joint?

Answer 22

contraction of the infraspinatus and teres minor

Question 23

what contributes to stability of shoulder joint?

Answer 23

rotator cuff, glenoid labrum, ligaments, biceps tendon

Question 24

What contributes to mobility of shoulder joint?

Answer 24

ball and socket joint. glenoid cavity small in relation to large humeral head. 1:4 disproportion