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?

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?

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
Which triad of symptoms are included in Reiter's syndrome (a form of reactive arthritis)?
Urethritis Uveitis/Conjunctivitis Arthritis
26
What causes gout?
High levels of uric acid, causing deposition of urate crystals within a joint
27
What is uric acid a product of?
The breakdown of purines in DNA metabolism (adenine, guanine)
28
What are gout tophi?
Painless white accumulations of uric acid that can erupt through the skin
29
How do gout crystals appear on polarised microscopy?
Negatively birefringent needle-shaped crystals
30
Outline treatment of acute gout
NSAID/colchicine (for those intolerant of NSAID) Steroid Analgesia
31
What is the drug of choice for sufferers of recurrent gout?
Allopurinol
32
What causes pseudogout?
Deposition of calcium pyrophosphate crystals
33
What does chondocalcinosis mean?
Deposition of calcium pyrophosphate crystals in cartilage in the absence of acute inflammation