Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Senior - Rhuem Chart > 3 - Arthritis > Flashcards

3 - Arthritis Flashcards

1
Q

MC inflammatory arthritis?

A

Rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MC pt population for RA?

A

Females 30-40’s

Males 50-70’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define RA

A

Chronic systemic inflammatory disease of UKN cause,

  • primarily targets the synovium
  • Leading to loss of articular cartilage and erosion of juxta-articular bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of RA?

A

Direct synovial infection :

  • mycoplasma
  • parvovirus
  • retroviruses

Molecular mimickry of QKRAA

Enteric bacterial infections

  • mycobacterial spp
  • EBV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Strongest association to RA?

A

HLA-DRB1

“Shared epitope”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of RA?

A

Insidious, chronic, symmetric arthritis of:

  • small joints
  • hands and writsts

Start in:

  • PIP
  • MCP
  • MTP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which joints are usually affected w RA

A

MCP, PIP, and MTP&raquo_space; Wrist, knee, elbow, ankles, hip, shoulders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Joints spared by RA?

A

DIPs

T/L spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Late joint deformities for RA?

A

Ulnar deviation of MCP
Boutonnier deformity
Swan-neck deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

With RA pts you must be careful?

A

With intubation

Risk of spinal injury with C1-C2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should be checked with RA joints?

A

Joint effusions - synovial fluid analysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Extra articular manifestations of RA?

A

Rheumatoid nodules
Episcleritis
Pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differenting from Sjogren’s sydrome?

A

RA is anti-Ro/Anti-La neg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Specific RA tests?

A

RF

Anti-CCP antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T, B, complement cells?

A

RA has an activation of T cells, B cells and complement within the synovium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Labs for RA?

A 
RF
ESR/CRP
CBC
Anti-CCP
ANA
Chem/LFT
Anemia
THrombocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Synovial fluid with RA?

A

WBC 5k-50k

- 75% neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Radiology for RA?

A

Juxta-articular erosions and joint-space narrowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PE for RA

A

Synovitis
Nodules
Splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

RA non-pharm therapies?

A 
Education
Exercise
Rest
Wt loss
PT/OT
Orthotic devices (splints)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pharmacologic therapies for RA?

A 
NSAIDS
Glucocorticoids
- DMARD bridge 
Synthetic DMARD
Biologic DMARD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Standard of care for RA?

A

Methotrexate + folic acid

23
Q

Synthetic DMARDs for RA?

A 
Methotrexate + folic acid
Lefluonomide
Sulfasalazine (combo tx)
Hydroxychloroquine
Minocycline (<2yrs only)
24
Q

Least effective synthetic DMARD?

A

Hydroxychloroquine

  • least effective
  • renal toxicity
25
Q

Biologic DMARDs problems?

A

Effective but more expensive

Increased risk for:

  • TB
  • Hep B/C
  • lymphoma
26
Q

Biologic DMARDS?

A

TNF-alpha inhibitiors

  • infliximab (remicade)
  • entanercept (enbrel)
  • adalimumab (humira)
  • golimumab (simponi)
  • certolizumab (cimzia)

Selective constimulation modifier
- abatacept (orencia)

Interlukin-1 receptor aganost
- anakinra

Monoclonial antibody

  • rituximab (rituxin)
  • tocilizumab (actemra)
27
Q

MC form of childhood arthritis?

A

Juvenile idiopathat arthritis

JIA

28
Q

Subgroups of JIA?

A
  1. Systemic
  2. Polyarticular (sero+/-)
  3. Oligoarticualr
  4. Psoriatic (not discussed)
  5. Enthesitis-related (not discussed)
29
Q

IOT be JIA pt must have?

A

> /= 6 weeks of persistent joint swelling

Excludes other types of childhood arthritis

30
Q

S/s of JIA?

A

> /= 6 weeks of joint swelling

Systemic symptoms

  • fevers
  • fatigue
  • pain
  • appear acutely ill
31
Q

Diagnostic criteria for JIA?

A
  1. Age <16
  2. Persistent joint swelling x 6 weeks
  3. Exclusion of other causes
32
Q

What are the diagnostic lab criteria for JIA?

A

None are diagnostic but:

RF + <20%
ANA + 85%

Often see increase in:

  • WBC
  • ESR
  • Ferritin
  • CRP
  • platelets
  • abnormal LFTs
  • Anemia
33
Q

Treatment for JIA?

A

Think RA, its similar

REFERRAL
NSAIDS
Glucocorticoids (oral and IA)
DMARDS (methotrexate)

34
Q

Who is prone to seropositive polyarticular arthritis?

A

Teenaged girls

35
Q

Seropositive polyarthritis has ___ joints involved?

A

> /= 5 at onset

36
Q

Seropositive polyarthritis has an ___ ___

A

Aggressive course

37
Q

Describe the course of seropositive polyarticular

A

Aggressive

  • Vasculitis
  • Nodules
  • Felty syndrome
  • Lung disease
  • Erosive joint disease
38
Q

What disease does seropositive polyarticular mimic?

A

Resembles the adult form of:

- classic rheumatoid factor positive RA

39
Q

Diagnostic criteria for seropositive polyarthicular arthritis?

A

Seropositive (+RF)

40
Q

Tx for seropositive polyarticular arthritis

A

Referral

NSAIDS
Glucocorticoids (oral, IA)
DMARDs (methotrexate)

41
Q

Seronegative polyarticular affects predominatly?

A

Girls = boys

8-12 y/o

42
Q

Seronegative polyarticular s/s?

A 
Poor wt gain/growth
May/may not be: 
- symmetric
- large joints
- knees
- ankles 
- wrists
43
Q

When are radiographic changes seen with Seronegative polyarticular?

A

May be several years before erosive changes are seen before erosive changes are seen on radiographs

44
Q

Diagnostic for Seronegative polyarticular?

A

Seronegative (-RF)

45
Q

Seronegative polyarticular tx?

A

REFERRAL
NSAIDS
Glucocorticoids (oral or IA)
DMARDS (methotrexate)

46
Q

What is the MC subgroup of JIA?

A

Oligoarticular

47
Q

Patient population for Oligoarticular?

A

Girls 1-7 y/o

48
Q

Diagnostic criteria for Oligoarticular?

A

<4 joint groups

49
Q

If Oligoarticular progresses to more than 4 joints what happens?

A

< 6 mo - polyarticular arthritis

> 6 mo - extended oligoarticular

50
Q

Oligoarticular pts complain of?

A

Morning stiffness

MC knees

51
Q

Diagnostic blood work for Oligoarticular?

A

ANA +

52
Q

ANA pos Oligoarticular pts are at a risk for?

A

Asymptomatic iritis

Get them to optho

53
Q

Oligoarticular tx?

A

Same as JIA

REFERRAl
NSAIDS
Glucocorticoids (oral, IA)
DMARDS (methotrexate)

Senior - Rhuem Chart (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions