Arthritis

Question 1

What are the different types of arthritis

Answer 1

OA
RA
Seronegative spondylarthropathies 
Infectious 
Crystal induced

Question 2

What are all the different types of seronegative spondyloarthropathies

Answer 2

Ankylosing spondylitis
Reactive
Enteric assoc
Psoriatic

Question 3

What are the different types of crystal induced arthritis

Answer 3

Gout

Pseudo gout

Question 4

What is the most common form of joint disease

Answer 4

OA

Question 5

What is OA

Answer 5

A degenerative change in the articulation cartilage causing structural changes and functional impairment

Question 6

What is the cause of OA

Answer 6

Can be primary : usually wear and tear

Secondary : injury, fat

Question 7

Features of OA

Answer 7

Morning stiffness <30 mins
Improves with rest
Worse on activity
Asymmetrical, big joint e.g shoulder, hip, knee
LOSS on xray
Bouchards ( proximal)
Herberdens ( distal) remember by HD definition

Question 8

Patient with OA, what does X-ray look like

Answer 8

Mnemonic : LOSS
L: loss of joint space ie cartilage loss
O : osteophytes 
S : subchondral sclerosis 
S: subchondral cysts

Question 9

Ix of OA

Answer 9

Examination

XR

Question 10

Treatment of OA

Answer 10

1. Physio
2. Topical NSAIDS, topical capsaicin
3. Oral NSAID
4. Sub acromial steroid injection
   Replacement

Question 11

What is the most common inflammatory arthritis

Answer 11

RA

Question 12

What is RA

Answer 12

Chronic inflammatory disorder, autoimmune attacking the joints

Question 13

Who most likely gets RA

Answer 13

Female

Question 14

Features of ra

Answer 14

Morning stiffness > 30 mins 
Affect small joints first
Improves with activity 
Can have exta articular manifestations 
Swan neck deformity 
Boutonnière 
Ulnar deviation of the metacarpophlangeal

Question 15

What are seronegative ones assoc with

Answer 15

HLA B27

Question 16

what % of psoriatic patient have psoriatic Arthritis

Answer 16

10%

Question 17

What is gout Assoc with

Answer 17

Urate metabolism ie hyperuricaemia

Question 18

What synthesising urine

Answer 18

Purine catabolism

So hyperuricaemia due to abnormal purine metabolism

Question 19

What cause urea excretion

Answer 19

Renal filtration, reabsorbed in proximal tubule

Question 20

What causes increase production of urea

Answer 20

Normally idiopathic

Question 21

What causes reduced excretion of urea

Answer 21

Chronic renal disease

Drug side effect: Thiazide diuretics

Question 22

What is the clinical manifestation of hyperuricaemia

Answer 22

Deposition of soft tissue - gouty tophus

Secondary degenerative change in the joint

Question 23

What causes pseudo gout

Answer 23

Calcium pyrophosphate

Question 24

What joint is most commonly affected in septic arthritis

Answer 24

Knee

Question 25

What is the mechanism of speed in septic arthritis

Answer 25

Haematogenous spread

Question 26

gonorrhoeae septic arthritis

Answer 26

Think of STI

Question 27

What is the definition of septic arthritis

Answer 27

Inflammation of joint space caused by infection

Can be blood borne organisms

Question 28

What are the causes of septic arthritis

Answer 28

S.aureus
Strep
Gonorrhoea
H.Influenza

Question 29

Ix of septic arthritis

Answer 29

JOINT ASPIRATION

Also: x ray for fractures, exclude crystals

Question 30

Treatment for septic arthritis

Answer 30

Give empirical antibiotics before joint aspiration
FLUCLOX
Less than 5 years old” add cetriazone for h. Influenza
Adjust organisms when confirmed
1-2 weeks IV , oral for 4- 6 weeks

Question 31

What are the viral causes of arthritis

Answer 31

Hep b

Rubella