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Medicine: PBL wrap-ups > Unit 5 Case 2: Osteoarthritis > Flashcards

Unit 5 Case 2: Osteoarthritis Flashcards

1
Q

definition of osteoarthritis

A

clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life

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2
Q

2 types of osteoarthritis

A

primary
secondary

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3
Q

primary osteoarthritis

A

more generalised
affects various parts of the body

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4
Q

secondary osteoarthritis

A

occurs after injury
typically injury that causes joint inflammation

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5
Q

histological changes seen in osteoarthritis

A

chondrocytes proliferate, cluster and form MMP’s
extracellular matrix will lose aggrecan, type 2 collagen degradation and cartilage cracks
cartilage will decrease swelling pressure of proteoglycans, altered collagen synthesis, loss of shock absorption

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6
Q

changes seen in osteoarthritis

A
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7
Q

different types of arthritis

A

rheumatoid
psoriatic
gout

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8
Q

rheumatoid arthritis

A

autoimmune disease
immune system attacks the joints
leads to inflammation
results in severe joint damage if left untreated

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9
Q

psoriatic arthritis

A

autoimmune inflammatory disease
causes raised, red and white patches of inflamed skin with scales normally on the elbows, knees, scalp and navel
can also swell the fingers and the toes

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10
Q

gout

A

form of inflammatory arthritis
more centralised
occurs when uric acid crystals build up in joints, results in painful inflammation
most often affects the big toe

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11
Q

healthy synovium

A

1-2 cells thick
macrophage like synovial cell, synoviocytes type 1
fibroblast like synovial cells type 2
synovial subliming is loose connective tissue with numerous blood and lymphatic vessels, nerves, scattered macrophages and fibroblasts

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12
Q

what is in the image

A
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13
Q

what is in the image

A
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14
Q

what is in the image

A
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15
Q

what is in the image

A
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16
Q

what is in the image

A
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17
Q

what is in the image

A
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18
Q

what is in the image

A
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19
Q

symptoms of osteoarthritis

A

pain
morning stiffness
tenderness
losss of flexibility
bone spurs
grating sensation
swelling

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20
Q

clinical presentation of osteoarthritis

A

hip tenderness
range of passive and active motion
crepitus with movement
pain when pressure is placed on the hip
gait problems
sign of injury to muscles, tendons and ligaments surrounding the hip

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21
Q

identify features of osteoarthritis on knee joint

A
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22
Q

identify features of osteoarthritis on hip joint

A
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23
Q

what is in the image

A
  1. heberden nodes
  2. Bouchard nodes
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24
Q

what is in the image

A

1st carpometacarpal joint squaring

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25
Q

describe the gait cycle

A
  1. initial contact of heel with floor
  2. weight transferred to this leg
  3. weight is aligned and balanced on this leg
  4. heel lifts off floor as foot rises, toes in contact with floor
  5. foot continues to rise, toes lift off floor
  6. foot swings forwards and comes back into contact with floor with a heel strike
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26
Q

examples of some different gaits

A

antalgic
hemiplegic
diplegia
ataxic
myopathic
neuropathic
parkinsonian
choreiform

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27
Q

antalgic gait

A

abnormal that develops as a result of pain, stance phase reduced on affected limb
means limp

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28
Q

choreiform gait

A

presents with involuntary movements

29
Q

myopathic gait

A

weakness of hip adductors
resulting in a waddling appearance

30
Q

neuropathic gait

A

caused by weakness of muscles in distal limb
due to damage to peripheral providing motor innervation

31
Q

parkinonian gait

A

caused by rigidity and bradykinesia
because of loss of dopaminergic neurone in basal ganglia nerves

32
Q

ataxic gait

A

broad-based, midline, cerebellar disease, vestibular disease
loss of proprioception

33
Q

diplegic gait

A

may Be caused by CNS lesion

34
Q

hemiplegic gait

A

caused by CNS lesion
unilateral weakness and spasticity

35
Q

clinical presentation of knee joint osteoarthritis

A

anatalgic gait
trendelenburg/myopathic/waddling gait
varus and valgus

36
Q

describe the image

A

varus: bow legged, knees curve outwards, leaving a wide space

valgus: knock knees, knees touch and feet are significantly apart when standing

37
Q

hallux valgus

A

clinical presentation of osteoarthritis in the feet
looks like gout
bunions of feet

38
Q

clinical presentation of hip joint osteoarthritis

A

trendelenburg test
c- sign

39
Q

trendelenburg test

A

stand on one leg and see if the opposite hip drops
positive sign= contralateral pelvic drop during single leg stance, could be superior nerve damage

40
Q

C-sign

A

pain anteriorly and laterally of hip
causes patient to grab the painful area, creates a c shape with their hand

41
Q

normal range of hip movement flexion

A

0-125

42
Q

normal range of hip movement extension

A

115-0

43
Q

normal range of hip movement external rotation

A

0-45

44
Q

normal range of hip movement internal rotation

A

0-45

45
Q

normal range of hip movement abduction

A

0-45

46
Q

normal range of hip movement adduction

A

45-0

47
Q

subchondral sclerosis

A

hardening of bone just below the cartilage surface
later stages of osteoarthritis
abnormally white bone along the joint line
common in knees and hips
area just below cartilage layer fills with collagen and becomes denser than healthy bone

48
Q

avascular necrosis of hip

A

damage of the blood supply that enters femoral head through neck of the femur bone can lead to the death of the femoral head
causes the femoral head to collapse and begin to flatten
flattening then causes the femoral head to not fit perfectly inside of the socket
joint then wears out

49
Q

what causes avascular necrosis of the hip

A

injuries
fractures
hip dislocation
medication, cortisone
excessive alcohol intake
deep-sea divers/ miners under high atmospheric pressure
causes tiny bubbles to form in the blood stream

50
Q

subchondral cyst

A

fluid-filled space inside a joint that extends from one of the bones that forms the joint
caused by osteoarthritis
may require aspiration

51
Q

what are the different risk factors for osteoarthritis

A

sex
older age
joint injuries
obesity
repeated stress on the joint
genetics
bone deformities
metabolic disorders

52
Q

sex as a risk factor for osteoarthritis

A

women are more likely

53
Q

joint injuries as a risk factor for osteoarthritis

A

even if this occurred years ago
could be from sports/accidnets etc

54
Q

obesity as a risk factor for osteoarthritis

A

extra body weight
extra joint stress
fat tissue produces proteins causing inflammation in/around joints

55
Q

bone deformities as a risk factor for osteoarthritis

A

some born with malformed joints/defective cartilage

56
Q

metabolic disorders as a risk factor for osteoarthritis

A

diabetes
hemochormatosis (body has too much iron)

57
Q

constitutional risk factors for osteoarthritis

A

ageing
hereditary
gender
hormonal status (menopause)
metabolic bone disease (Pagets)

58
Q

local risk factors for osteoarthritis in the knee

A

obesity
quadriceps weakness
joint laxity/malalignment

59
Q

local risk factors for osteoarthritis in the hip

A

developmental dysplasia
occupation

60
Q

pharmacological management of osteoarthritis

A
61
Q

non-pharmacological management of osteoarthritis

A
62
Q

surgical management of osteoarthritis

A
63
Q

NICE guidelines for osteoarthritis treatment

A

exercise and physiotherapy is the first line of treatment
patient education= self management support
weight management
medication management
surgery is last resort
referral to specialist services

64
Q

NICE guidelines for information giving

A

chunk and check
discussions
patient decision aids
3 talk model: choice, options, preferences given then to make an informed decision

65
Q

drugs used in the treatment and management of osteoarthritis

A

paracetamol
aspirin
curcumin
rosehip extract
naproxen
glucosamine
chondroitin
omeprazole

MOA in separate flashcards

66
Q

definition of coping

A

process of using behavioural and cognitive approaches to manage difficult or threatening situations and plays on an integral role in maintaining physical and mental well-being of an individual

67
Q

what can coping be

A

emotion focused or problem solving strategies
adaptive or maladaptive strategies

68
Q

internal coping factors

A

biological or psychological behaviour

69
Q

external coping factors

A

social influences

Medicine: PBL wrap-ups (21 decks)

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