Day: May 4, 2024

This is a term used to describe inflammation of the blood vessel walls. It leads to generalised inflammatory symptoms (fever, fatigue, weight loss and myalgia) as well as symptoms according to which organ or tissue is affected secondary to the regional ischaemia.   Large Vessel Vasculitis These conditions involve inflammation of the large arteries like the aorta and its major branches. Temporal (giant cell) Arteritis This is a granulomatous vasculitis involving branches of the carotid artery. This leads to patches of inflammation which “skips” parts of the affected artery. It is the most common vasculitis in adults older than the

Systemic lupus erythematosus (SLE) This is a chronic systemic autoimmune disease, which is classically seen in middle-aged women, particularly in black and Hispanic demographic groups. Whilst the exact cause is unknown, poorly cleared apoptotic debris activates autoimmune lymphocytes leading to the generation of immune complexes. Inadequate clearance (due to deficient complement proteins) means that these immune complexes are deposited in multiple tissues, leading to inflammation. It can also be drug induced, which is associated with higher anti-nuclear antibodies than anti-double stranded DNA antibodies. It typically displays a relapsing and remitting pattern of disease. Symptoms Inflammatory signs – fever, weight loss,

Systemic lupus erythematosus (SLE) This is a chronic systemic autoimmune disease, which is classically seen in middle-aged women, particularly in black and Hispanic demographic groups. Whilst the exact cause is unknown, poorly cleared apoptotic debris activates autoimmune lymphocytes leading to the generation of immune complexes. Inadequate clearance (due to deficient complement proteins) means that these immune complexes are deposited in multiple tissues, leading to inflammation. It can also be drug induced, which is associated with higher anti-nuclear antibodies than anti-double stranded DNA antibodies. It typically displays a relapsing and remitting pattern of disease. Symptoms Inflammatory signs – fever, weight loss,

Osteoarthritis This is a condition where there is progressive degeneration of the articular cartilage. It is a non-inflammatory arthritis which occurs due to “wear and tear” of the joint. It usually affects the hips, knees, and the distal interphalangeal joints of the hand. Risk factors include age, obesity, occupation (e.g., strenuous job) and trauma.   Symptoms Non-inflammatory joint pain (stiffness < 30 minutes), affecting individual joints in a non-symmetrical pattern Joint pain that worsens during the day Joint clicking (crepitus), instability May have joint effusion or antalgic gait Bony enlargements in fingers, called Heberden’s nodes (DIP joints) and Bouchard’s nodes

Achondroplasia This is the most common cause of dwarfism, which occurs due to a gene mutation in the receptor that converts cartilage to bone during development. It is due to an activating mutation (usually sporadic) in FGF3 (autosomal dominant). This gene is found in chondrocytes and inhibits growth favouring differentiation. Whilst endochondral ossification is affected, there is normal intramembranous bone formation meaning that patients have a normal skull and torso but short limbs. It leads to dwarfism with short limbs but a normal head and chest size.   Symptoms Short limbs with normal head and chest   Management Growth hormone

Achondroplasia This is the most common cause of dwarfism, which occurs due to a gene mutation in the receptor that converts cartilage to bone during development. It is due to an activating mutation (usually sporadic) in FGF3 (autosomal dominant). This gene is found in chondrocytes and inhibits growth favouring differentiation. Whilst endochondral ossification is affected, there is normal intramembranous bone formation meaning that patients have a normal skull and torso but short limbs. It leads to dwarfism with short limbs but a normal head and chest size.   Symptoms Short limbs with normal head and chest   Management Growth hormone

Osteoarthritis This is a condition where there is progressive degeneration of the articular cartilage. It is a non-inflammatory arthritis which occurs due to “wear and tear” of the joint. It usually affects the hips, knees, and the distal interphalangeal joints of the hand. Risk factors include age, obesity, occupation (e.g., strenuous job) and trauma.   Symptoms Non-inflammatory joint pain (stiffness < 30 minutes), affecting individual joints in a non-symmetrical pattern Joint pain that worsens during the day Joint clicking (crepitus), instability May have joint effusion or antalgic gait Bony enlargements in fingers, called Heberden’s nodes (DIP joints) and Bouchard’s nodes

A fracture is a medical condition where the continuity of the bone is broken. When describing a fracture, it is essential to describe the type and severity of the fracture. Adequate description includes providing information about a number of different categories: Open or closed? Closed fracture = a broken bone with no open wound Open fracture = a broken bone with a break in the skin   Simple or comminuted? Simple = a fracture where the bone is broken into two fragments Comminuted = bone is splintered or crushed into several pieces   Angle of break? Transverse = this is

Osteoarthritis This is a condition where there is progressive degeneration of the articular cartilage. It is a non-inflammatory arthritis which occurs due to “wear and tear” of the joint. It usually affects the hips, knees, and the distal interphalangeal joints of the hand. Risk factors include age, obesity, occupation (e.g., strenuous job) and trauma.   Symptoms Non-inflammatory joint pain (stiffness < 30 minutes), affecting individual joints in a non-symmetrical pattern Joint pain that worsens during the day Joint clicking (crepitus), instability May have joint effusion or antalgic gait Bony enlargements in fingers, called Heberden’s nodes (DIP joints) and Bouchard’s nodes

Systemic lupus erythematosus (SLE) This is a chronic systemic autoimmune disease, which is classically seen in middle-aged women, particularly in black and Hispanic demographic groups. Whilst the exact cause is unknown, poorly cleared apoptotic debris activates autoimmune lymphocytes leading to the generation of immune complexes. Inadequate clearance (due to deficient complement proteins) means that these immune complexes are deposited in multiple tissues, leading to inflammation. It can also be drug induced, which is associated with higher anti-nuclear antibodies than anti-double stranded DNA antibodies. It typically displays a relapsing and remitting pattern of disease. Symptoms Inflammatory signs – fever, weight loss,

This is a term used to describe inflammation of the blood vessel walls. It leads to generalised inflammatory symptoms (fever, fatigue, weight loss and myalgia) as well as symptoms according to which organ or tissue is affected secondary to the regional ischaemia.   Large Vessel Vasculitis These conditions involve inflammation of the large arteries like the aorta and its major branches. Temporal (giant cell) Arteritis This is a granulomatous vasculitis involving branches of the carotid artery. This leads to patches of inflammation which “skips” parts of the affected artery. It is the most common vasculitis in adults older than the

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. – It is detected by nociceptors, which are thinly myelinated Ad or unmyelinated C fibres – free nerve endings – These nociceptors have specific ion channels which respond to noxious stimuli, to initially signal pain.   –> TRPV1 activated by heat and capsaicin –> TRPM8 activated by cold and menthol   After tissue damage, many chemicals stimuli stimulate nociceptors, including ATP (released from damaged cells) and H+ ions, released in anaerobic metabolism. – These excite and stimulate nociceptors. – Nociceptor activation gives peptide release leading

The immune response can be split into the innate and adaptive system:   Innate Immunity This is immunity which is dependent on antigen receptors that are germline encoded   The innate immune system recognizes 3 types of stimulants, which activate the innate response: – Pathogen associated molecular patterns (PAMPs) – molecular shapes specific to the pathogen – Danger associated molecular patterns (DAMPs) – self-molecules released by host stressed cells – Missing-self – Infected cells do not show normal self-antigens which protect host cells from NK cells.   The activation of these receptors gives acute inflammation and activation of the following

The lower limb comprises of three main joints – the hip, knee and ankle. Hip This is formed of the head of the femur interacting with the acetabulum– The articular surface of the acetabulum is a horseshoe – finished by transverse ligament and fibrocartilage labrum.– Fovea of femoral head connects to acetabulum by ligamentum teres. The capsule is attached around acetabulum to the femoral neck, above trochanters.– It is strengthened by 3 ligaments –ischiofemoral, pubofemoral and iliofemoral (this is the strongest Y-shaped which goes from AIIS to intertrochanteric line preventing hyperextension)   Muscles:These are categorized by their actions on the

The upper limb mainly comprises of three main joints – the shoulder, elbow and wrist.   Shoulder This is a synovial ball-and-socket joint. The surface area of the humeral head is 3x that of the glenoid fossa.The capsule is strengthened by coracohumeral ligaments and 3 anterior glenohumeral ligaments.   Muscles:These can be described by the action they cause on the joint. The shoulder is stabalised by the rotator cuff muscles which attach onto greater tuberosity of humerus, expect teres minor (lesser tuberosity) i) Abduction:– Supraspinatus –> provides the initial 15 degrees of abduction, by suprascapular nerve – Deltoid –> From acromion onto

The long bones that make up the body have a distinct structure, and can be subdivided into many parts: – Bones usually have high levels of compressional and tensile strength, but less torsional strength.   Term Definition Diaphysis The shaft of the bone – This is made up of compact bone which has a dense structure  Epiphysis The end of the bone – This is made up of cancellous/spongy bone. – Made of sheets of trabeculae that branch to form a sponge like network. Epiphyseal line Also known as the growth plate – Separates the Diaphysis and Epiphysis during development

This is a term used to describe inflammation of the blood vessel walls. It leads to generalised inflammatory symptoms (fever, fatigue, weight loss and myalgia) as well as symptoms according to which organ or tissue is affected secondary to the regional ischaemia.   Large Vessel Vasculitis These conditions involve inflammation of the large arteries like the aorta and its major branches. Temporal (giant cell) Arteritis This is a granulomatous vasculitis involving branches of the carotid artery. This leads to patches of inflammation which “skips” parts of the affected artery. It is the most common vasculitis in adults older than the

Systemic lupus erythematosus (SLE) This is a chronic systemic autoimmune disease, which is classically seen in middle-aged women, particularly in black and Hispanic demographic groups. Whilst the exact cause is unknown, poorly cleared apoptotic debris activates autoimmune lymphocytes leading to the generation of immune complexes. Inadequate clearance (due to deficient complement proteins) means that these immune complexes are deposited in multiple tissues, leading to inflammation. It can also be drug induced, which is associated with higher anti-nuclear antibodies than anti-double stranded DNA antibodies. It typically displays a relapsing and remitting pattern of disease. Symptoms Inflammatory signs – fever, weight loss,