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Y2 CONTROL & MOVEMENT > Arthritis > Flashcards

Arthritis Flashcards

1
Q

How many joints are examined when a new patient is seen in clinic?

A

78 joints are examined

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2
Q

What, in basic, is arthritis?

A

Inflammation of the joints

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3
Q

What type of joints are the majority of joints in the body?

A

synovial joints

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4
Q

What are the four features that comprise every synovial joint?

A
  1. articular cartilage
  2. synovial membrane
  3. fibrous capsule
  4. synovial fluid
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5
Q

What is significant about the way in which the synovial joint is designed?

A

It allows for transmission of loads across the joint and movement of bone ends relative to each other with minimal friction and wear

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6
Q

What parts of the synovial joint are involved in reducing friction?

A

articular cartilage and synovial fluid

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7
Q

What is the difference between a simple joint and a complex joint?

A

a simple joint contains 2 articulating surfaces

a complex joint contains more than 2 articulating surfaces

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8
Q

How does arthritis affect the synovial joint?

A

the synovial membrane pumps out pro-inflammatory chemicals

this leads to more synovial fluid being produced

the synovial lining becomes thicker

inflammation of the joint can be felt

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9
Q

What is the main aim of arthritis management?

A

to reduce inflammation and make the patient feel better

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10
Q

What is often a side effect of arthritis, due to reduced ability to work?

A

depression due to pain and restricted ability to do normal day to day things

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11
Q

What is the most common type of arthritis?

A

osteoarthritis

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12
Q

What does cartilage look like on an X-ray?

A

Cartilage does not show up on an X ray

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13
Q

What is a main factor that escalates the severity of osteoarthritis?

A

obesity

this is because there is more weight putting pressure on the joints

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14
Q

What chemical can worsen osteoarthritis in obese people?

A

fatty tissue releases lectins

these cause inflammation all over the body

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15
Q

What are the stages of development of osteoarthritis?

A
  1. layer of cartilage over the joint begins to flake away with age
  2. this causes a low level of inflammation within the joint
  3. the joint lining becomes inflamed and produces more synovial fluid
  4. this leads to inflammation
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16
Q

What are the final 2 stages in advanced osteoarthritis development?

A
  1. the joint starts to remodel once all the cartilage has worn away

osteocytes (bits of bone that have regrown) form

  1. large cysts form within the bone
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17
Q

How can you tell if osteocytes have developed?

A

you can feel lumps on the bones as they change shape

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18
Q

Why does osteoarthritis lead to weaker muscles?

A

Due to the pain of the swelling, people use the muscles less around the affected joint

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19
Q

How do weakened muscles affect the progression of osteoarthritis?

A

Weak muscles cause the pain to become worse

the muscle strength is not there to support the damaged joint

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20
Q

How is osteoarthritis diagnosed?

A

Through clinical examination and X-Ray findings

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21
Q

What blood tests are used to diagnose osteoarthritis?

A

There are no specific blood tests

Antibody and CRP tests should be normal

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22
Q

What is the most common clinical finding in a patient with osteoarthritis?

A

Crepitis and osteocytes (bony swellings)

this is the feeling/sound of grinding/crunching

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23
Q

What other organs can be affected by osteoarthritis?

A

OA does not affect other organs, only the joints

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24
Q

What causes inflammatory arthritis?

A

It is autoimmune - the immune system attacks the synovial lining, leading to inflammation

25
Q

What is a common symptom of someone with inflammatory arthritis?

A

Stiffness that lasts for more than 30 minutes in the morning

26
Q

What blood tests can be used to diagnose inflammatory arthritis?

A

Raised CRP and ESR

They are not raised very high (around 20-40)

27
Q

What other signs are present with inflammatory arthritis?

A
  1. definite joint swelling

2. inflammatory back pain

28
Q

What age range does inflammatory arthritis affect?

A

Any age range, not just older people

29
Q

What causes rheumatoid arthritis?

A

It is autoimmune

antibodies are produced that fight the joints and cause inflammation

30
Q

What gender and age range are most commonly affected by rheumatoid arthritis?

A

females

most common age is 40-50s

31
Q

What joints are most commonly affected by rheumatoid arthritis?

A

the small joints of the hands and feet

32
Q

What are the clinical signs of rheumatoid arthritis that a patient will mention?

A
  1. joint swelling with heat and pain

2. morning stiffness

33
Q

What are the 2 blood tests that can be used to diagnose rheumatoid arthritis?

A

Rheumatoid factor

CCP antibody

34
Q

What is significant about rheumatoid arthritis being ‘systemic’?

A

It can affect other organs

35
Q

What is the basis of treatments for rheumatoid arthritis?

A

suppression of the immune system

36
Q

How can joints affected by rheumatoid arthritis be easily identified?

A

Rheumatoid nodules develop

37
Q

Why can foot ulcers develop in untreated rheumatoid arthritis?

A

they develop due to vasculitis

this is inflammation of the blood vessels

38
Q

What is significant about rheumatoid arthritis and cardiovascular health?

A

any condition that causes inflammation leads to increased cardiovascular risk, especially in smokers

39
Q

How may treatment for rheumatoid arthritis negatively affect the patient?

A

due to immunosuppression, they are more likely to contract rarer diseases and septic arthritis

40
Q

Why is there an increased osteoporosis risk in rheumatoid arthritis?

A

Steroid injections/tablets are used to treat RA

They are toxic to bones and increase risk of osteoporosis

41
Q

What is the danger of osteoporosis?

A

A reduction in bone strength leads to an increased risk of fracture

42
Q

What is spondyloarthritis?

A

any form of arthritis that causes inflammation within the spine

43
Q

What is psoriasis?

A

scaly white plaques on the skin

usually in the hair or on the elbows

44
Q

What % of people with psoriasis go on to contract psoriatic arthritis?

A

10%

45
Q

What are the 2 characteristics of psoriatic arthritis?

A

Iritis - red inflamed eyes

Achilles - inflammation of tendon sites

46
Q

Does psoriatic arthritis affect other organs?

A

Yes, but not as much as rheumatoid arthritis

47
Q

What is dactylitis and when is it seen?

A

“sausage toes/fingers”

inflammation of the tendon in the finger/toe leads to a very swollen appearance in psoriatic arthritis

48
Q

What is meant by telescoping in psoriatic arthritis?

A

The joints shrink down into themselves

This is no longer painful when it has been present for a long time

49
Q

What age range tends to be affected by ankylosing spondylitis?

A

Younger people

It is more common in men

50
Q

What are the side effects of ankylosing spondylitis?

A
  1. inflammatory back pain
  2. iritis
  3. achilles tendon
51
Q

How can ankylosing spondylitis affect the spine if it is left untreated?

A

The spine can become fused

The ligament coming in front of the spine becomes ossified

The patient cannot rotate their spine and it becomes stuck in a single position

52
Q

What is the most common example of crystal arthritis?

A

gout

53
Q

What causes gout?

A

having too much uric acid in the body

if there is too much, it cannot dissolve in the blood and forms crystals in the joints

54
Q

Why is paracetamol not given to gout patients?

A

It is very painful

55
Q

What are tophi?

A

Lumps of uric acid crystal that form commonly on ears, fingers and the elbow

56
Q

What can increase the risk of gout?

A
  1. genetic disposition
  2. beer and red wine
  3. more common in men
57
Q

How can untreated gout affect the bones?

A

permanent bone damage known as a rat bite erosion

58
Q

What is pseudo-gout?

A

calcium pyrophosphate crystals (not uric acid) that cause similar symptoms to gout

Y2 CONTROL & MOVEMENT (69 decks)

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