2- Inflammatory Arthropathies Flashcards

1
Q

List features suggestive of joint inflammation

A
Joint pain
Swelling
Morning stiffness
Improvement with exercise
Synovitis
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2
Q

What is the most prevalent seropositive arthropathy?

A

Rheumatoid arthritis

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3
Q

Men are more affected than women by RA. True/False?

A

False

Women 3:1 men

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4
Q

What age is the typical onset of RA?

A

35-50yrs

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5
Q

There is a genetic component to RA. True/False?

A

True

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6
Q

What is the basic pathogenesis behind RA?

A

Autoimmunity; synovium becomes inflamed and destroys articular cartilage, causing joint destruction

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7
Q

List clinical features of RA

A

Symmetrical synovitis
Pain
Morning stiffness
Rheumatoid nodules

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8
Q

Which joints in the hand are affected my RA?

A

MCP
PIP
Wrist

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9
Q

Which autoantibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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10
Q

XR is useful at the onset of RA. True/False?

A

False

Often shows no joint abnormality in early stages

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11
Q

Outline treatment for RA

A
DMARDs
NSAIDs
Analgesia
Injected/oral steroid
Biologics
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12
Q

List the main seronegative arthropathies

A

Ankylosing spondilitis
Psoriatic arthritis
IBD arthritis
Reactive arthritis

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13
Q

Which HLA is often associated with seronegative arthropathies?

A

HLA-B27

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14
Q

Where does ankylosing spondilitis usually affect?

A

Spine

Sacroiliac joints

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15
Q

Who is more affected by AS - males or females?

A

Males 3:1 females

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16
Q

What is the age of onset of AS?

A

20-40yrs

17
Q

List clinical features of AS

A

Spinal pain/stiffness
Improvement with exercise
Loss of lumbar lordosis
Increased thoracic kyphosis

18
Q

Which test is used to assess lumbar spine flexion?

A

Schobers test

19
Q

What does AS show on XR?

A

Sclerosis/fusion of sacroiliac joints
Syndesmophytes (bony spurs)
“Bamboo spine”

20
Q

Outline treatment for AS

A

NSAIDs
Physiotherapy
Anti-TNF

21
Q

Psoriatic arthritis is usually symmetrical. True/False?

A

False

22
Q

What are the main nail changes that occur in psoriatic arthritis?

A

Onycholysis

Pitting

23
Q

Which GU infections can typically cause reactive arthritis?

A

Chlamydia

Neisseria

24
Q

Which GI infections can typically cause reactive arthritis?

A

Salmonella

Campylobacter

25
Q

Which triad of symptoms are included in Reiter’s syndrome (a form of reactive arthritis)?

A

Urethritis
Uveitis/Conjunctivitis
Arthritis

26
Q

What causes gout?

A

High levels of uric acid, causing deposition of urate crystals within a joint

27
Q

What is uric acid a product of?

A

The breakdown of purines in DNA metabolism (adenine, guanine)

28
Q

What are gout tophi?

A

Painless white accumulations of uric acid that can erupt through the skin

29
Q

How do gout crystals appear on polarised microscopy?

A

Negatively birefringent (yellow) needle-shaped crystals

30
Q

Outline treatment of acute gout

A

NSAID/colchicine (for those intolerant of NSAID)
Steroid
Analgesia

31
Q

What is the drug of choice for sufferers of recurrent gout?

A

Allopurinol

32
Q

What causes pseudogout?

A

Deposition of calcium pyrophosphate crystals

33
Q

What does chondocalcinosis mean?

A

Deposition of calcium pyrophosphate crystals in cartilage in the absence of acute inflammation