Brainscape's Knowledge GenomeTM

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


See full index

ANKI Rheumatology > Ankylosing Spondylitis > Flashcards

Ankylosing Spondylitis Flashcards

1
Q

What type of disease in ankylosing spondylitis (AS)?

A

seronegative spondyloarthropathy

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

What other diseases are part of the Group of Sponylorarthritides?

A
  1. Psoriatic arthritis
  2. Enteropathic arthritis
  3. Reactive arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What gene is AS associated with?

A

HLA-B27

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

What is AS?

A

chronic progressive inflammatory arthropathy lead to radiological change in spine and sacroiliac joints

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

What are causes of AS?

A
  1. HLA-B27 gene: in 90%
  2. FHx
  3. Male
  4. ERAP-1 and IL-23R gene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is classic epid of AS?

A
  1. Age of onset <40 (late teens and early 20s) years and back pain lasting >3 months
  2. Male
  3. Prevelance: 0.25-1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are classic symptoms and signs of AS?

A
  1. Inflammatory bank pain
  2. Iritisi/uveitis
  3. Enthesitis
  4. Fatigue
  5. Sleep disturbance
  6. Kyphosis
  7. Progressive loss of spinal movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the back pain like in AS?

A
  1. insidious onset
  2. worse in morning
    3, improve with exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are possible DDx for AS?

A
  1. Osteoarthritis
  2. Diffuse idiopathic skeletal hyperostosis (DISH)
  3. Psoratic arthritis
  4. Reactive arthritis
  5. Infection
  6. Bony metastases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What imaging is used for AS?

A
  1. MRI back

2. Pelvic X ray

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

Why do you do a MRI back?

A

detection of active inflammation and destructive changes

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

What would MRI back show in AS?

A
  1. Vertebral syndesmophytes are characteristic (T11-L1 initially)
  2. Bony proliferations due to enthesitisisbetween ligament and vertebrae, these fuse with the vertebral body above causing ankylosis
  3. bone marrow oedema (early)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What bloods are done and what do they show in AS?

A
  1. FBC: normocytic anaemia
  2. ESR: high
  3. CRP: high
  4. HLA-b27 positive
  5. Rh negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is 1st line treatment for AS?

A

NSAID e.g. naproxen 500mg 2x daily and exercise

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

What else would be added to the treatment of AS?

A
  1. Analgesia
  2. Intra-articular corticosteroid injection (if local intra-articular inflammation)
  3. Sulfasalazine or methotrexate (if peripheral joint involvement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When may a TNF-alpha inhibitor and physiotherapy be used for AS?

A

if enthesitis and/or peripheral arthritis

17
Q

What are possible complications for AS?

A
  1. Osteoporosis
  2. Cardiac involvement
  3. Hip involvement
  4. Iritis
  5. Pulmonary involvement
  6. Neurological involvement
18
Q

When is the prognosis worse for AS?

A
  1. ESR>30
    2, onset <16yrs
  2. early hip involvement
  3. poor response to NSAIDs
19
Q

What is seen the pathogonominic radiographic feature seen in AS?

A

bamboo spine

20
Q

What does the inflammation start in AS?

A
  1. at sites of attachment of ligaments to the vertebral bodies (first in lumbar region)
  2. progresses to cervical and thoracic spine
  3. Potentially infective triggers?
21
Q

What is enthestisis?

A
  1. plantar fasciitis
  2. Achilles’ tendonitis
  3. dactylitis
22
Q

What is the extrarticular manifestations of AS?

A
  1. Anterior uveitis (40%)
  2. Apical lung fibrosis
  3. Aortic regurgitation
    • Psoriasis, IBD Sx
23
Q

What is needed for diagnosis of AS?

A

> 3 months inflammatory back pain, with sacroiliac joints + axial spine affected > peripheral joints

24
Q

What is the defintion of AS?

A

Chronic, progressive inflammatory arthropathy of axial skeleton
+ Peripheral joints, entheses (tendon/ligament attachments) & extra-articular sites

25
Q

What are the special clinical tests for AS?

A
  1. (Modified) Schober’s test
  2. Tragus to wall
  3. Stress test
26
Q

What is modified schober’s test?

A
  1. tests lumbar motility
  2. Mark 2 points: 10cm above L5, 5cm below
  3. Patients bends forward
  4. Point-point distance increases <5cm means AS
27
Q

What is tragus to wall test?

A
  • Physiological <15cm

- Increased in AS

28
Q

What happens in Stress Tests e.g., Gaenslen’s?

A

Sacroliac joint pain

29
Q

What would XR show in AS?

A
  1. sacroiliitis (early)

2. syndesmophytes and bamboo spine (late)

30
Q

What test results show AS?

A
  1. Schober’s test <20cm total
  2. Bloods: Raised ESR/CRP, ACD, Rh negative
  3. Genetic test: HLA B27 +ve 90-95%
  4. XR: sacroiliitis (early), syndesmophytes & bamboo spine (late)
  5. MRI: bone marrow oedema (early)
  6. Lung function tests: impairment from kyphosis
31
Q

What medication is used in AS?

A
  1. NSAIDs
  2. Steroids during flares – oral, IM or intraarticular
  3. Anti-TNF
  4. Secukinumab – IL17 mAb
  5. Physiotherapty + smoking cessation + bisphosphonates for osteoporosis
  6. ?Surgery
32
Q

What is the grading used for sarcoillitis?

A

New York

33
Q

What is the New York grading for scaroillits?

A
  • grade 0: normal
  • grade I: suspicious changes (some blurring of the joint margins)
  • grade II: minimum abnormality (small localised areas with erosion or sclerosis, with no alteration in the joint width)
  • grade III: unequivocal abnormality (moderate or advanced sacroiliitis with erosions, evidence of sclerosis, widening, narrowing, or partial ankylosis)
  • grade IV: severe abnormality (complete ankylosis)
34
Q

What are late changes in AS?

A
  1. Kyphosis
  2. Loss of lumbar lordosis
  3. Neck extension

ANKI Rheumatology (14 decks)

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