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3RD YEAR - Long Term Conditions/FOCP > Arthritis > Flashcards

Arthritis Flashcards

1
Q

What is reactive arthritis?

A

A type of joint inflammation which occurs within 4 weeks post-infection, typically an STD. It commonly presents with arthritis, conjunctivitis and urethritis.

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2
Q

What is SLE?

A

Systemic Lupus Erythematosus is a relapsing-remitting autoimmune condition which causes joint pain, raynauds, oral/genital ulcers and a distinctive malar ‘butterfly’ rash which is nasolabial sparing.

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3
Q

What is a common respiratory complication of SLE?

A

Pleuritis

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4
Q

What is a common respiratory complication of Rheumatoid Arthritis?

A

ILD or pulmonary nodules

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5
Q

Name 4 different types of inflammatory arthritis

A

Rheumatoid, Ankylosing Spondylitis, Reactive, Psoriatic

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6
Q

What points should be covered in an arthritis history?

A 
Pain
Swelling
Stiffness
Function
Joints affected
Diurnal variation
General malaise
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7
Q

What is rheumatoid arthritis?

A

An autoimmune condition causing symmetrical, inflammatory polyarthritis

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8
Q

What are some systemic features of rheumatoid arthritis?

A
  • Scleritis
  • Interstitial lung disease, nodules
  • Pericarditis
  • Skin nodules
  • Cervical myelopathy
  • Mononeuritis multiplex
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9
Q

What is osteoarthritis?

A

Chronic and progressive asymmetrical joint pain caused by cartilage loss and bone remodelling

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10
Q

What are the four characteristic features of osteoarthritis on X-ray?

A
  1. Subchondral sclerosis
  2. Joint space narrowing
  3. Osteophyte formation
  4. Subchondral cysts
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11
Q

What are the features of rheumatoid arthritis on X-ray?

A
  1. Juxta-articular osteopenia
  2. Soft tissue swelling
  3. Joint deformity
  4. Joint space narrowing
  5. Ill-defined marginal erosions
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12
Q

Which rheumatological condition typically causes dry eyes and mouth?

A

Sjorgens syndrome

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13
Q

What can cause back pain?

A

Prolapsed disc, trauma, fractures, ank spon, pregnancy, malignancy, paget’s, cauda equina, osteoporotic vertebral collapse, spinal infection

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14
Q

What is the treatment for septic arthritis?

A

IV flucloxacillin or vancomycin

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15
Q

What are some examples of DMARDS?

A

Methotrexate
Hydroxychloroquinine
Sulfasalazine

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16
Q

What is the main side effect of DMARDS?

A

Immunosuppresion

17
Q

What are some examples of biologics?

A

TNFa inhibitors: infliximab, etanercept, adalimumab
B cell depletion: Rituximab

These are usually used in combo with methotrexate

18
Q

What would be recorded on a joint aspiration in gout?

A

Monosodium urate crystals

19
Q

What are the typical signs and symptoms of ankylosing spondylitis?

A
  • Young man
  • Gradual onset lower back pain, worst at night
  • Morning stiffness relieved by exercise
  • Global loss of spinal movement
  • Question mark posture
  • Bamboo spine (symmetrical blurring and narrowing of the joint space) on X-ray (NB this can only be seen in advanced disease)
20
Q

Which HLA is involved in ank spon?

A

HLA B27

21
Q

What happens to the hands in rheumatoid arthritis?

A
  • Swelling of PIP joints
  • Ulnar deviation
  • Swan-necking
  • Z-thumb
  • Loss of bone density
  • Rheumatoid nodules
22
Q

What happens to the hands in osteoarthritis?

A
  • Affects first MCP joint and DIPs
  • Heberdens nodes (outer)
  • Bouchards nodes (inner)
23
Q

What features can be seen on x-ray of psoriatic arthritis?

A

Sausage finger, pencil in cup deformity

24
Q

What is systemic sclerosis?

A

An autoimmune disease of connective tissue, characterised by thickened skin and vascular damage

25
Q

What is dermatomyositis?

A

Insidious onset of progressive symmetrical proximal muscle weakness and inflammation, causing a characteristic purple rash around the eye and rash on the hands.

26
Q

How does carpal tunnel syndrome usually present?

A
  • Parasthesia in the fingers which is worse at night and occasionally feels like burning
  • Positive phalanx sign
  • Usually idiopathic
27
Q

What is the classical presentation of polymyalgia rheumatica?

A
  • Aged over 50
  • 2 weeks of bilateral shoulder pain
  • Evidence of acute phase response (raised ESR and CRP)
  • Morning stiffness
28
Q

What is the most common cause of posterior knee swelling?

A

Baker’s cyst

29
Q

In which condition would you get well defined periarticular erosions in the affected joint?

A

Chronic gout

30
Q

What is the difference between the aspirate from gout and pseudogout?

A

Pseudogout - bifringent rhomboid crystals

Gout - negatively bifringent needle-shaped urate crystals

31
Q

What tends to occur in radial nerve palsy?

A

Wrist drop (wrist extensor muscles are controlled by radial nerve)

32
Q

What is Finkelstein’s test?

A

Take the patients thumb and ulnar deviate the hand sharply. This elicits sharp pain along the distal radius and is a sign of de Quervain’s tenosynovitis

33
Q

What tests assess for median nerve palsy?

A

Phalen’s and Tinel’s

34
Q

What test assess for ulnar nerve palsy?

A

Froment’s sign

35
Q

What is a common side effects of DMARDs such as methotrexate?

A

Immunosuppresion

36
Q

If someone has severe rheumatoid arthritis, on what condition can they try biologics?

A

They must have tried low-dose glucocorticoids and two trials of six months of traditional DMARD monotherapy or combination therapy.

DMARDS - azothiaprine, ciclosporin, hydroxychloroquine, methotrexate

BIOLOGICS - infliximab

37
Q

What does post-surgical DVT increase the likelihood of?

A

Pulmonary embolism - the best investigation for this is a CT pulmonary angiogram

38
Q

What causes the following nail changes:

a) clubbing
b) heberden’s nodes
c) koilonychia
d) nail plate separation from nail bed (oncholysis)
e) nail thinning

A

a) respiratory problems
b) osteoarthritis
c) iron-deficiency anaemia
d) psoriatic arthritis
e) lichen planus

39
Q

What four conditions is HLAB27 associated with?

A

PAIR

Psoriasis
Ankylosing spondylitis
Inflammatory bowel disease
Reactive arthritis

3RD YEAR - Long Term Conditions/FOCP (39 decks)

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