Arthritis Flashcards

1
Q

What are the 2 main joint examinations?

A
  • GALS

- REMS

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2
Q

What does GALS stand for?

A

Gait, Arms, Legs and Spine.

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3
Q

What does REMS stand for?

A

Regional Examination of the Musculoskeletal System.

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4
Q

Which joint examination is more thorough?

A

REMS.

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5
Q

What is rheumatoid arthritis?

A

Chronic inflammation of joints.

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6
Q

What proportion of the population are affected by rheumatoid arthritis?

A

1%.

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7
Q

What deformities does rheumatoid arthritis lead to? (2)

A
  • Joint deformity (swan neck)

- Rheumatoid nodules (over bony prominences)

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8
Q

Why are rheumatoid nodules very rare now?

A

Due to improved treatments.

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9
Q

What is the pattern of rheumatoid arthritis deformities?

A

Occurs symmetrically, mainly proximal phalangeal joints.

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10
Q

What vascular problem can rheumatoid arthritis lead to?

A

Vasculitis.

-inflammation of the vascular system

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11
Q

What joints are mainly affected by rheumatoid arthritis?

A

Fingers
Feet
Elbows

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12
Q

What is osteoarthritis?

A

Degeneration of synovial joints and underlying bone&raquo_space; progressive destruction of hyaline cartilage.
-‘wear and tear’

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13
Q

What makes osteoarthritis so painful?

A

Cartilage is destroyed&raquo_space; bones rub together.

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14
Q

What joints are mainly affected by osteoarthritis?

A

Weight-bearing joints/digits.

-hip, knee, thumb

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15
Q

What nodes form due to osteoarthritis? (2)

A
  • Heberden’s nodes

- Bouchard’s nodes

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16
Q

What position did osteoarthritis used to lead to?

A

‘Windswept’ position.

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17
Q

What is primary osteoarthritis?

A

Osteoarthritis without a known cause.

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18
Q

What proportion of 75-79 year olds are affected by osteoarthritis?

A

85%.

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19
Q

Which gender is osteoarthritis more common in in

A

More common in males.

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20
Q

What is the familial pattern found in some cases of osteoarthritis?

A

Mutation of type II collagen.

21
Q

What is secondary osteoarthritis?

A

Osteoarthritis that is caused by another disease/condition.

-e.g. obesity, trauma, surgery

22
Q

What causes secondary arthritis?

A

Injury to the joint.

-e.g. bleeding, stress, inflammation

23
Q

What causes psoriatic arthritis?

A

PSORIASIS; skin condition&raquo_space; red patches on skin with silvery flakes.

24
Q

Which areas of the body does psoriasis commonly affect?

A

Elbows, knees, bottom.

25
Q

Which joints does psoriatic arthritis normally affect?

A

Any joint in the hand.

26
Q

What deformity does psoriatic arthritis lead to?

A

Dactylitis.

  • ‘sausage digit’
  • inflammation of the digit
  • shortened digits
27
Q

What is gout?

A

Defective metabolism of uric acid&raquo_space; arthritis and chalk-stone deposits.

28
Q

What joints are most commonly affected by gout?

A

Smaller joints in the feet.

29
Q

What are the 2 main types of gout?

A
  • Acute podagra

- Chronic tophaceous gout

30
Q

What is acute podagra?

A

Very painful arthritis due to gout.

-usually affects 1-2 joints

31
Q

What is chronic tophaceous gout?

A

Nodular tophi (uric acid crystals) are deposited in soft tissue areas.

32
Q

What is another name for Still’s disease?

A

Juvenile chronic arthritis.

33
Q

What are the main effects/symptoms of Still’s disease? (3)

A
  • Joint inflammation
  • Rash (lasting ~1/2 an hour)
  • Splenomegaly
34
Q

What condition is ‘prayer sign’ present in?

A

Diabetes mellitus.

-cannot straighten fingers when hands are together

35
Q

What is rheumatology?

A

The study of arthritis and other disorders of joint/muscles/ligaments.

36
Q

List some other rheumatological conditions.

A
  • Hypercholesterolaemia
  • Ankylosing spondylitis
  • Ricketts
  • Scurvy
  • Dermatomyositis
  • Marfans
  • Pseudo-gout
  • Milwaukee shoulder
  • Acromegaly
  • Vasculitis
37
Q

What problem does hypercholesterolaemia lead to in the heels?

A

Xanthelasma on the heel (yellow plaques).

-cannot straighten heel properly

38
Q

What is ankylosing spondylitis?

A

Arthritis of the spine.

-joints fuse if untreated&raquo_space; stiffened spine

39
Q

What used to be the treatment for ankylosing spondylitis?

A

Radiotherapy.

-but lead to leukaemia and skin cancer

40
Q

What is Ricketts?

A

Vitamin D deficiency.

-leads to swelling on chest wall, decreased growth and knees bow out (» osteoarthritis)

41
Q

What is the main source of vitamin D?

A

Sunlight.

42
Q

What is scurvy?

A

Vitamin C deficiency.

|&raquo_space; spontaneous bleeding from skin and joints

43
Q

What are the main signs of dermatomyositis? (2)

A
  • Heliotropic rash around eyes/knuckles

- Muscle inflammation

44
Q

How is dermatomyositis treated?

A

Steroids and immunosuppressants.

45
Q

What is Marfans?

A

Defect in fibrinogen (collagen component) .» longer, hypermobile limbs, eye lens dislocation, aortic aneurysm.
-affects all collagen

46
Q

What is pseudo gout?

A

Inflammation of joints due to deposits of calcium pyrophosphate crystals.
-not uric acid

47
Q

What crystals are deposited to cause Milwaukee shoulder?

A

Calcium hydroxyaptite crystals.

48
Q

What is acromegaly?

A

Increased growth hormone&raquo_space; increased growth of body tissue and larger hands/feet.
-leads to 2* osteoarthritis

49
Q

Name 3 types of vasculitis.

A
  • Henoch-Schoenlein purpura
  • Erythema nodosum
  • Lupus pernio