Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Arthritis > Flashcards

Arthritis Flashcards

1
Q

What is osteoarthritis?

How does it occur?

A

Imbalance between breakdown and repair of articular cartilage

Result from mechanical stress (repeated trauma, obesity etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of Osteoarthritis are…

A

Insidious:

  • Aching, poorly localised pain (Worse with activity, better with rest)
  • Reduced motion
  • Limp
  • Crepitus
  • Bony enlargement (Heberden’s DIP /Bouchard’s nodes PIP)
  • Bowing/knock-knees
  • Joint swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What joints are commonly affected by OA?

A
  • Hips
  • Knees
  • Spine
  • Small hand/foot joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s the joint fluid like in OA?

A

Non-inflammatory (WBC <1,500)

Yellow, Clear fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Osteoarthritis X-rays show?

A

FLOSS:

  • Flattened bone
  • Loss of joint space
  • Osteophytes (Bone spur growth)
  • Subchondral cysts
  • Subchondral sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for OA

A

Analgesia
Paracetamol, NSAIDs, Topical NSAIDs, capsaicin, IA injections (steroids, hyaluronic acid)

Surgery for specific joint (non-operative options exhausted + impact QoL)

Exercise, weight loss (even if painful)
Stop painful activities
Heat packs, TENS, functional aids
Physio for muscle strengthening, prevent falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment steps for OA

A
  1. Holistic assessment - pain and comorbidities
  2. Core (self-treatment, info, weight loss)
  3. Non-pharmacological (heat packs, OT aids)
  4. Pharmacological
  5. Surgical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is rheumatoid arthritis?

A

Autoimmune disease attacking joints
Destruction of bone + Cartilage
Inflamed synovium
Joint instability, Chronic pain, loss of/poor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of Rheumatoid Arthritis

A
  • Morning stiffness, improved with activity
  • Affects more than three joints, persists >6 weeks
  • Swelling of hand joints (PIP, MCP, not DIP)
  • Ulnar deviation/Boutonniere’s deformity
  • Symmetrical swelling
  • Extra-articular features (anaemia, subcutaneous nodules, vasculitis, interstitial lung disease, sarcopenia) Sjogren’s)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s the joint fluid like in RA?

A

Turbid yellow (high WBC <50,000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigations for RA?

A

Rheumatoid factor +ve in >85%

Anti-CCP antibody positive in 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Imaging findings in RA?

A
  • Soft tissue swelling
  • Erosions
  • Deformity
  • Joint space narrowing
  • Periarticular osteopenia
    (Bony changes are late stage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for RA?

A

DMARDs: Methotrexate (XXX PREGNANCY), Sulfasalazine
Biologics - ok in pregnancy!: TNF-a inhibitors e.g. etanercept, adalimumab, (best combo with DMARD)
Corticosteroids (Oral, IM, IA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Gout?

A

Inflammation of 1+ joints due to uric acid crystal deposits in joints or tissues
(Most common Inflammatory arthritis in men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gout Risk Factors?

A
  • Obesity
  • Alcohol
  • Dietary purines
  • Chronic renal insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of Gout?

A

Episodic acute joint pain
90% monoarticular (1st MTP joint is most common)
Precipitated by trauma, surgery, alcohol, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What’s the joint fluid like in Gout?

A 
Crystals present (diagnostic)
(high WBC >50,000 - similar to septic arthritis)
18
Q

Investigations for gout?

A

Joint aspiration; sodium urate crystals.
High serum uric acid (may be normal)
Blood culture to exclude septic arthritis

19
Q

Gout X-ray findings?

A

Negative bar soft tissue swelling

Calcium in articular cartilage (chondrocalcinosis) pathognomic for pseudogout

20
Q

Management of Gout?

A

Acute: NSAIDs, Colchicine (dysuria side effect), Steroids (MUST NOT BE SEPTIC A)

Prophylaxis: Allopurinol, uricosuric agents, canakinumab, lifestyle factors

21
Q

What is Septic Arthritis?

A

Acute arthritis due to infection, normally bacterial, from haematogenous seeding (travel in blood)
Unusual organisms and site seen in IVDUs (PWIDs)

22
Q

Risk Factors for Septic Arthritis?

A

Older, previous joint pathology, skin infection, DM

23
Q

Symptoms of Septic Arthritis?

And what joints does it normally affect?

A

Abrupt joint swelling and pain, fever, inflammation and pain (both passively and actively)
50% in knee, Sternoclavicular joint in IVDUs (PWIDs)

24
Q

What’s the joint fluid like in Septic Arthritis?

A

Most commonly Staph aureus
IVDUs - Pseudomonas
Very high WBC (50,000-100,000)

25
Q

Investigations for septic arthritis?

A

Bloods: High WBC, High ESR, High CRP
Imagining: negative - maybe soft tissue swelling

26
Q

What is Seronegative Arthritis?

Give examples

A

Multisystem disease
Inflammatory arthritis without rheumatoid factor in the blood

Ankylosing spondylitis psoriatic arthritis, IBD-linked arthritis, reactive arthritis

27
Q

Spondylitis vs Spondylosis?

A

Spondylitis is inflammation affecting the vertebrae, and 1+ vertebral joints

Spondylosis is degeneration of intervertebral discs

28
Q

Presentation of Seronegative Arthritis?

A

Mainly axial skeleton: Low back pain, Spine curvature loss, fixed flexion of knees and hips
Enthesitis and Dactylitis
Peripheral arthritis of skin, arms, legs, eyes, gut

29
Q

What is Ankylosing Spondylitis?

A

Type of seronegative arthritis
Chronic inflammation of vertebral joints - as well as entheses and peripheral joints.
Can also affect the gut

30
Q

Treatment of Ankylosing Spondylitis?

A 
Physiotherapy
NSAIDs (short-term)
DMARDs (sulfasalazine)
Biologics (anti-TNF e.g. infliximab, etanercept)
Osteoporosis treatment
31
Q

Presentation of Ankylosing Spondylitis?

A 
Majority young men
Inflammatory back pain
Bilateral sacroiliitis
High CRP
Painful eye
HLA B27 positive
positive Schobers test
32
Q

What is Psoriatic Arthritis?

A

Inflammatory arthritis that primarily affects skin and joints - can affect axial skeleton
Spectrum and overlaps with RA and AS

33
Q

Symptoms of Psoriatic Arthritis?

A

Psoriatic skin and nail changes (plaques, pitting, onycholysis)
Morning joint stiffness
Enthesitis and Dactylitis
Involvement of DIP joints (unlike RA)

34
Q

Treatment for Psoriatic Arthritis?

A 
Physiotherapy
Occupational therapy for functional aids
DMARDs (sulfasalazine, methotrexate)
Biologics (anti-TNF)
Steroids (few IA injections per year if monoarthritis)
NSAIDs
35
Q

What is Reactive Arthritis?

A

Sterile inflammation

Post-infection outside the joint capsule

36
Q

Symptoms of Reactive Arthritis?

A 
Post-infectious (salmonella, shigella, campylobacter, borrelia, neisseria, strep)
Systemic disease
1 -4 joints arthritic
Enthesitis and Dactylitis
Affects skin and mucus membranes
37
Q

Treatment for Reactive Arthritis?

A

NSAIDs
Steroids (IA injections)
Antibiotics for chlamydia (acute)
NSAIDs and DMARDs (chronic)

38
Q

Things that exacerbate gout?

A

Bendroflumethiazide (thiazide diuretics - normally for oedema and hypertension), ACEi
Purine rich foods
Alcohol and sugary drinks

39
Q

What is Pseudogout?

Compared to gout

A

Type of Crystal Arthritis
Calcium pyrophosphate - not sodium urate crystals - in knee not toes
Elderly women not men
Intercurrent illness not associate with uric acid (tophi)

40
Q

Treatments for Pseudogout?

A

NSAIDs
Steroids (IA injections)
(acute)
- unlikely to reoccur

MSK (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions