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PHTH 565 - Rheumatology > Ankylosing Spondylitis > Flashcards

Ankylosing Spondylitis Flashcards

1
Q

2 areas of inflammation of the spine?

A
  1. sacroiliitis

2. spondylitis

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2
Q

_________ affects peripheral joints of the body, legs > arms and is typically on one side of the body

A

synovitis

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3
Q

_______ = inflammation where ligaments, tendons and joint capsule attach to bone

A

enthesopathy

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4
Q

Does blood work of spondyloarthritis usually show RF?

A

NO

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5
Q

Tendency for spondyloarthritis to run in families (T/F).

A

TRUE

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6
Q

_______ = sausage like fingers and toes due to swelling, seen in psoriasis

A

dactylitis

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7
Q

________ = in psoriasis, especially in heels and back

A

enthesitis

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8
Q

Psoriatic arthritis = affects __-__% of those with ideas

A

15-30

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9
Q

Male and female prevalence in psoriasis? Age of onset?

A

male = female; 30-50, can begin in childhood

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10
Q

5 subgroups of psoriatic arthritis ?

A
  1. DIP arthritis
  2. olygoarthritis less than or equal to 2-4 joints (asymmetric)
  3. symmetrical polyarthritis
  4. arthritis mutilans
  5. SI joins and spine (psoriatic spondylitis)
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11
Q

Can psoriatic arthritis have conjunctivitis / iritis in the eye?

A

Yes

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12
Q

Spondylitis and iritis = more common in people who are _____ +

A

HLA-B27

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13
Q

Enteropathic spondylitis = ______ arthropathy

A

intestinal

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14
Q

Enteropathic spondylitis may affect the ____ and ___ joints, also joints in the legs and arms

A

spine; SI

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15
Q

Reactive arthritis = generally (asymmetrical/symmetrical)

A

asymmetrical

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16
Q

Reactive arthritis usually occurs in the _____ limbs.

A

lower

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17
Q

Reactive arthritis = triggered by infection in the _____ or ________ tract

A

bowel; genitourinary

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18
Q

AS = stiffness / fusing of the spine by ______

A

inflammation

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19
Q

AS = essentially a disease of ______ _______

A

young adults

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20
Q

Average age of AS?

A

26

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21
Q

Contracture of which joints are common in AS?

A

hip and knee

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22
Q

Gender ratio of AS?

A

1:1

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23
Q

Cause of AS?

A

unclear

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24
Q

AS associated with genetic marker ____-____

A

HLA-B27

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25
Q

___ - ___ % of people with AS are HLA B27+

A

90-95

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26
Q

MSK involvement of AS?

A
  1. sacroiliitis
  2. enthesitis
  3. synovitis
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27
Q

4 other systems + organs involved in AS?

A
  1. eyes
  2. bowel
  3. lungs
  4. heart
28
Q

_______ = hallmark sign of AS

A

sacroiliitis

29
Q

Sacroiliitis is more common (bilaterally/unilaterally)

A

uni

30
Q

______ leads to bony erosion, bony overgrowth (syndesmophytes), possible bony fusion and rigidity

A

enthesitis

31
Q

Enthesitis in AS = inflammation starts in __ joints, progresses in ascending fashion affecting all levels of spine

A

SI

32
Q

Common sites for enthesitis can include both ____ and ______ regions

A

spine; periph

33
Q

Dx of enthesitis time?

A

up to 5-6 years

34
Q

Early stage enthesitis ?

A

bony loss –> osteopenia

35
Q

Later stage enthesitis ?

A

OP –> risk of #

fusion/rigidity –> risk of #

36
Q

______ usually affects peripheral joints, including the shoulder, hips and knees

A

synovitis

37
Q

In synovitis, involvement of joints may precede, accompany or follow ______ involvement

A

spinal

38
Q

In synovitis, peripheral joint involvement occurs in __% of cases

A

30

39
Q

AS pt’s will have (increased/decreased) lung capacity

A

decreased

40
Q

Definite AS = if _______ criterion is associated with at least 1 _____ criterion

A

radiologic; clinical

41
Q

Radiologic criterion for AS?

A

sacroilitis grade >/= 2 bilaterally or grade 3-4 unilaterally

42
Q

Iritis and uveitis = ___ % in AS cases

A

30

43
Q

Increase in CV risk __-__ fold in AS

A

2-3

44
Q

Pain in spondyloarthritis = worse after ___, intermittent or persistent

A

rest

45
Q

Sources of pain in spondyloarthritis include what 4 things?

A
  1. enthesitis
  2. sacroiliitis
  3. synovitis
  4. muscle spasm
46
Q

Stiffness in spondyloarthritis?

A

am stiffness in spine

47
Q

Stiff in spondyloarthritis after periods of _______, relieved with ______

A

inactivity; movement

48
Q

ROM in spine in pt’s with spondyloarthritis decreases in which directions?

A

All

49
Q

Decreased strength in spondyloarthritis due to what 3 things?

A
  1. disuse
  2. joint effusion
  3. pain
50
Q

____ posture in spondyloarthritis

A

flexion

51
Q

Changes in what 2 joints limits lateral costal breathing in spondyloarthritis?

A
  1. cosotchondral

2. costovertebral

52
Q

5 new criteria for inflammatory back pain (> 3 months)?

A
  1. improvement with exercise
  2. pain at night
  3. insidious onset
  4. age of onset < 40 years
  5. no improvement with rest
53
Q

8 standardized measures in arthritis assessment?

A
  1. tragus to wall
  2. lateral flexion
  3. trunk flexion
  4. extension
  5. rotation
  6. breathing
  7. neck side flexion
  8. neck rotation
54
Q

5 common enthesitis sites for PsA?

A
  1. achilles
  2. patella
  3. plantar fascia
  4. anseranus bursa
  5. greater trochanter of femur
55
Q

4 ways to manage spondyloarthritis ?

A
  1. medication
  2. physical interventions
  3. lifestyle / self-management
  4. sx
56
Q

DMARDS (are/are not) effective in axial disease

A

are NOT

57
Q

_________ are responsive to all domains

A

biologics

58
Q

6 key recommendations for PT in pt’s with AS?

A
  1. PT should start ASAP once dx
  2. PT Ax should be detailed and use outcome measures, rx should be based on clinical status
  3. PT should occur regardless of disease status
  4. lifelong regular exercise is mainstay of rx
  5. flexibility, stretching, breathing ex’s, pool ex’s, land ex’s and recreational activities recommended
  6. PT modalities should be used as adjunctive therapies based on use in MSK disorders
59
Q

4 ways to control inflammation?

A
  1. activity / rest
  2. ice
  3. compression
  4. exercise
60
Q

3 ways to increase mobility / decrease stiffness?

A
  1. exercise
  2. pool
  3. manual therapy
61
Q

3 R’s in sx management of spondyloarthritis?

A
  1. realign
  2. rest
  3. replace
62
Q

Realign in sx mangement?

A

osteotomy

63
Q

Rest in sx mangement?

A

arthrodesis

64
Q

Replace in sx mangement?

A

arthroplasty

65
Q

9 clinical features in AS?

A
  1. pain
  2. stiffness
  3. decreased ROM
  4. decreased strength
  5. deformity/instability
  6. altered posture/muscle imbalances
  7. altered breathing mechanics
  8. fatigue
  9. deconditioning
66
Q

3 clinical criteria for AS ?

A
  1. LBP w/ stiffness for more than 3 months that improves with exercise but is not relieved by erst
  2. limitation of motion of the L spine in both the sagittal and frontal planes
  3. limitation of chest expansion relative to normal values correlated for age and sex

PHTH 565 - Rheumatology (8 decks)

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