Pathological Changes in Osteoarthritis

Pathological Changes in Osteoarthritis

1. Remodeling of bone contour


2. Fibrillation and focal loss of hyaline cartilage


3. Marginal Osteophytes (ossification of new fibro-cartilage)


4. Subchondral sclerosis


5. Cysts


6. Secondary Bursitis


7. Capsular Thickening


8. Osteochondral Body


9. Synovial Hyperplasia


10. Secondary enthesopathy

What is enthesopathy?

In medicine, an enthesopathy refers to a disorder involving the attachment of a tendon or ligament to a bone. This site of attachment is known as the entheses.

If the condition is known to be inflammatory, it can more precisely be called an enthesitis.

Previous Year FCPS questions on “Pathological Changes in Osteoarthritis”

Pathological Changes in Osteoarthritis (FCPS July 2012)

1. Marginal Osteophytes


2. Remodeling of bone


3. Capsular thinning


4. hypoplastic synovial membrane


5. Subchondral Sclerosis

Ans: T T F F T

Pathological Changes in Osteoarthritis (FCPS Jan 2011)

1. Secondary Bursitis


2. Cysts formation


3. Osteochondral Body


4. Enthesopathy


5. Subchondral Sclerosis

Ans: T T T T T

Features of Osteoarthritis (FCPS July 2010)

1. Deformity of joints


2. Coarse crepitus due to rough articular surface


3. Bouchard’s nodes at distal interphalangeal joints


4. Heberden’s nodes at proximal interphalangeal joints


5. Structural changes are permanent

Ans: T T F F T

Bouchard’s node

Bouchard’s nodes are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints (the middle joints of fingers or toes.)

Heberden’s node

Heberden’s nodes are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).

Pathological Changes in Osteoarthritis

Autosomal Dominant Disorders Mnemonic

Autosomal Dominant Disorders Mnemonic

There are several Autosomal Dominant Disorders Mnemonic present. I have collected all.

One of the simplest one is:

Mnemonic for autosomal dominant disorders is :

“Very Powerful DOMINANT Humans”

V– Von willibrands disease/ Von hippel lindau

P – Pseudo hypoparathyroidism

D – Dystrophia myotonica

O – Osteogenesis imperfecta/Osler-weber-rendu

M – Marfans syndrome

I – Intermittent porphyria

N – Neurofibramatosis

A – Achondroplasia, Adult polycystic kidney disease

N – Noonans syndrome

T– Tuberous sclerosis

H – Hypercholestrolemia

H – Huntington’s disease

H – Hypertrophic obstructive cardiomyopathy

H – Hereditary spherocytosis

H – Hereditary non polyposis coli

H – Hereditary hemorrhagic telengiectasia

Most of the time you can just remember the part “DOMINANT”

Autosomal dominant diseases mnemonic with a visual covering

Osler Family is Hyper because Mary Huntington Von Turbo Sphereing MEN Across Hill.

• Osler-Weber-Rendu syndrome (Osler


• Familial hypercholesterolemia (Family Hyper)


• Marfan’s syndrome (Mary)


• Huntington’s disease (Huntington)


• Von Recklinghausen’s Disease (Von)


• von Hippel-Lindau disease (Von)


• Tuberous sclerosis (Turbo)


• Hereditary spherocytosis (Sphereing)


• Multiple endocrine neoplasias (MEN)


• Achondroplasia (Across)


• Hypokalemic periodic paralysis (Hill)


• Autosomal dominant polycystic kidney disease (ADPKD)

The picture shows a young Mary Huntington sphereing a globe full of MEN across a hill and she appears to be winning or probably have just won (Von), which makes the Osler Family very mad and hyper. Also note that the whole sphereing event is hosted by the ADPKD foundation.

Autosomal Dominant Disorders Bengali Mnemonic

“এক নিউ ফ্যামিলির মেয়ে পলি হেরে ভান করিয়া মার খেল”

এক = Achondroplasia

নিউ = Neurofibramatosis

ফ্যামিলি = Familial hypercholesterolemia, Familial adenomatous polyposis

মেয়ে = Myotonic Dystrophy

পলি = Polycystic kidney disease (ADPKD)

হেরে = Hereditary spherocytosis (Sphereing)

ভান = Von Recklinghausen’s Disease (Von), Von Hippel-Lindau disease (Von)

করিয়া = Huntington’s disease (Huntington Chorea)

মার = Marfan’s syndrome

Reference:

1. http://www.medical-institution.com/mnemonic-for-autosomal-dominant-disorders/

2. http://www.medpreponline.com/2012/12/autosomal-dominant-diseases-mnemonic.html

Autosomal Dominant Disorders Mnemonic

Regulators of Bone Re-modelling

Regulators of Bone Re-modelling

Table of Davidson 25.2 (Page 1062)

Factor | Bone resorption |Bone formation

Parathyroid hormone (PTH) ↑ ↑

Receptor activator of nuclear factor kappa B ligand (RANKL)↑ ↔

Osteoprotegerin (OPG) ↓ ↔

Sclerostin (SOST) ↔ ↓

Interleukin-1 (IL-1) ↑ ↓

Tumour necrosis factor-α (TNF-α) ↑ ↓

Thyroid hormone ↑ ↑

Glucocorticoids ↑ ↓↓

Oestrogen/testosterone ↓ ↑

Mechanical loading ↓ ↑

Bone Re-modelling Process with the Regualtors

It starts with the attraction of osteoclast precursors in peripheral blood to the target site, probably by local release of chemotactic factors from areas of micro damage. The osteoclast precursors differentiate into mature osteo­clasts in response to RANKL, which is produced by osteocytes, activated T cells and bone marrow stromal cells. RANKL activates the RANK receptor, which is expressed on osteoclasts and precursors. This is blocked by osteoprotegerin (OPG), a decoy receptor for RANKL that inhibits osteoclast formation. Mature osteoclasts attach to the bone surface by a tight sealing zone, and secrete hydrochloric acid and proteolytic enzymes such as cathepsin K into the space underneath. The acid dissolves the mineral and cathepsin K degrades collagen. When resorption is complete, osteoclasts undergo programmed cell death, and bone formation begins with the attraction of osteoblast precursors to the resorption site. These differentiate into mature osteoblasts, which deposit new bone matrix in the resorption lacuna, until the hole is filled. Some osteoblasts become trapped in bone matrix and differentiate into osteocytes. These act as biomechanical sensors and produce several molecules that influence bone remodeling and phosphate metabolism. Bone formation is stimulated by Wnt proteins, which bind to and activate lipoprotein related receptor protein 5 (LRP5), expressed on osteoblasts. This process is inhibited by SOST, which is produced by osteocytes.

Ref – Davidson 22 Edition ( Page – 1062)

Regulators of Bone Re-modelling

Apply Online CCD (Certificate Course on Diabetology) Birdem

Apply Online for CCD (Certificate Course on Diabetology) Birdem

There are two sessions each year- January to June and July to December.

** Application for online registration for next CCD batch 22 is going on until 7 May 2015.***

You can get details about the course from here:

http://www.badas-dlp.org/pages/course

Apply Online for CCD (Certificate Course on Diabetology) Birdem

But the Problem is you can never find the Registration link. I found, So click the apply now button below to get the registration form. After you filled it correctly, you can apply there. Then they will provide you a registration number.

This is the sample form

Apply Now for CCD Registration

After Completion of the form you will get a message like this:

Congratulation! Your Application has been Submitted Successfully, Your Registration Number is: 14697

Result will be published in the website and in the notice board.

If you are selected then please come with the following papers at the time of admission.

1. 2 copy Passport Size Photograph

2. Attested Photocopy of MBBS Certificate.

3. Attested Photocopy of BMDC Registration.

4. Attested Photocopy of SSC Certificate.

Course and admission procedure

There are two sessions each year- January to June and July to December.

The steps of getting admission and appearing ECE are:

Advertisement in leading newspapers and web-site.

Online submission of application by properly filled form to get a registration  number .

Display of selected candidates list on the DLP website and notice board.

Selected candidates will have to deposit course fee of taka 22500 (Twenty two thousand five hundred) through cash to the cash counter of BIRDEM.

Receiving student’s ID number by submitting the electronic money receipt (of the course fee) to the DLP office.

Attending the inaugural session on due date, then to start regular tutorials as per calendar.

Students eligible for ECE will have to deposit taka 3000 (Three thousand ) to the cash counter of BIRDEM to get an Admit Card from DLP office.

A student will be ‘course-out’ if he/she is unable to pass the ECE within two years of admission.

Successful students will be awarded Certificate in due time. The best performer in ECE will be awarded gold medal.

Please bookmark this page “Apply Online for CCD (Certificate Course on Diabetology) Birdem” for future updates of CCD course.

Apply Online CCD (Certificate Course on Diabetology) Birdem

What is Adson's Sign? Significance of Adson's Sign

Adson’s Sign

Adson’s sign is the loss of the radial pulse in arm by rotating head to the ipsilateral side with extended neck following deep inspiration. It is used as a sign of thoracic outlet syndrome (TOS).

Thoracic Outlet Syndrome Nerve Root Affected:

C8 / T1

Structures Causing Constriction in Thoracic Outlet Syndrom

1. Scalenus Anticus Syndrome

2. Cervical Rib Syndrome

3. Costoclavicular Syndrome

4. Carpal Tunnel Syndrome

5. Frozen Shoulder

Adson’s Sign Test Video

https://youtu.be/z5uIH69ke4E

Artery Supply of Superior Extremity

Significance of Adson’s Sign

Adson’s sign is no longer used as a positive diagnosis of TOS since many people without TOS will show a positive Adson’s.

 

What is Adson's Sign? Significance of Adson's Sign

What is main d'accoucheur?

Waht is main d’accoucheur?

main d’accoucheur is a French word which means “hand of the obstetrician“.

Children are more liable to develop tetany than adults and present with a characteristic triad of carpo-pedal spasm, stridor and convulsions, although one or more of these may be found independently of the others. In carpopedal spasm, the hands adopt a characteristic position with flexion of the metacarpophalangeal joints of the fingers and adduction of the thumb (‘main d’accoucheur’).

Trousseau sign Elicitation Video

 main d’accoucheur Picture

The sign is named after French physician Armand Trousseau who described the phenomenon in 1861. It is distinct from the Trousseau sign of malignancy.

What is main d'accoucheur?

Grays’s Anatomy 40 Edition PDF Download

Gray’s Anatomy 40 edition is one of the best anatomy book of medical first year. Though the book looks so heavy and big the contents will cover the all anatomy sectors of human medical science. In a nutshell we can call “Gray’s Anatomy” the bible of the anatomy.

Gray’s Anatomy 40 Edition PDF

PDF version of Gray’s Anatomy 40 edition is little bit rare for the medical students. Earlier I found the .CHM version of Gray’s Anatomy. But .CHM is not so compatible for the android device or any lumia device to read. So I have come to this time with latest pdf version of Gray’s Anatomy book.

The book is only 110 Mb with rar.

ISBN-13: 978-0443066849 ISBN-10: 0443066841 Susan Standring PhD DSc (Author)

Procedure to download Gray’s Anatomy 40 Edition PDF

Go to below link and give Captcha and then go to direct link and download.

You need to download the single 110MB rar file.

(After giving captcha you can see the link) You need to unrar the file, for those please use Winrar software or 7zip. You will ask for password during unrar, so please click any of the support buttons and unlock the password

Password to unrar

medipicture.com_GA_40

Gray’s Anatomy 40 Edition PDF Torrent Link: Here

Grays’s Anatomy 40 Edition PDF Download