Wk 27 - CNS OTC (MSK) Flashcards
What is the counselling points for OA?
- Joint protection
- Weight loss
- Keep active - exercise little + often
What are the symptoms of gout?
- Inflammation
- Redness
- Unilateral attack on big toe or tarsal joint
- Tophus
- Hyperuricaemia
What are the risk factors of gout?
- Alcohol
- Diabetes
- Red meat
- Obesity
- Renal disease
- Diuretics
What are the complications of gout?
- Tophi: inflamed
- 2ndry infection
- Hyperuricemia induced renal disease
How is gout diagnosed?
Clinical history + examination
What is the treatment for gout?
- NSAIDs: continue 48 hrs after attack has resolved
- If regular, co-prescribe w/ PPI
- If ineffective refer
- If CI add paracetamol w//w/o codeine
What are the counselling points for gout?
- Rest + elevate limb
- Keep joint cool
- Aim IBW
- Restrict red meat + avoid high protein intake
- Drink sensibly
- Stop smoking
- Avoid dehydration
- Don’t stop prophylaxis meds
What is used to prevent gout?
- Allopurinol: +2 attacks w/in a year, 1-2 wks after inflammation, titrate til SUA < 300 micromol/L
- Febuxostat 2nd line
When would you refer for gout?
- Pregnant
- <25 yrs
- Allopurinol/febuxostat at max dose + still recurrent
- CI NSAIDs
What is tendonitis?
Sudden stress causing tendons to rupture: pain, inflammation + loss of movement
What is bursitis?
- Inflammation of bursa
- Swelling + limited movement
- Rest + cool then apply heat after 48hrs
What is fibritis (fibromyalgia)?
- Aching at multiple sites
- Stiffness
- Lethargy
- Tension headache
- IBS
- Steroid injection for ST relief
What does PRICE stand for?
- Protect
- Rest: Avoid activity for 1st 48-72 hrs
- Ice: 15-20 mins every 2-3 hrs
- Compression: first 2-3 days + remove before sleep
- Elevate: above heart first 48hrs
What does HARM stand for?
- Heat
- Alcohol: inc bleed + swelling
- Running
- Massaging: inc bleed + swelling
What is first line for sprain/strain?
Paracetamol w/ topical NSAIDs
What are the symptoms of whiplash?
- Neck pain + stiffness
- Tenderness/red neck movements
- Headache
- Delayed 6-12 hrs
What are the counselling points for whiplash?
- Head + neck straight initially
- Early mobilisation
- Sleep w/ rolled towel
- Analgesics
What are the symptoms + treatment of carpal tunnel syndrome?
- Symptoms: numbness, tingling + swelling
- Treatment: wrist splint at night, corticosteroid injection or surgery
Which group of people are most affected by muscle cramps?
Children, esp at night
What are the causes of leg cramps?
- Hyponatraemia (heat + sweat)
- Hypo/hyperkalemia
- Hypocalcaemia (thyroidism)
- Hypomagnesaemia
- Hypolglycaemia
Which drugs cause cramps?
- Salbutamol
- Raloxifene
- Opiate w/drawal
- Diuretics
- Statins
What is used to manage cramps?
- Passive stretching + massage of affected muscle
- Pillow to raise feet through night
When would you refer MSK?
- Severe arthritis
- Back pain w/ abn urination
- Back pain radiating to leg
- Suspected fracture
- Head injury
- Treatment failure
- ADR
