Brainscape's Knowledge GenomeTM

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


See full index

Ortho & Rheum > Arthritis > Flashcards

Arthritis Flashcards

1
Q

Define osteoarthritis.

A

non-inflammatory disorder of moveable joints due to loss/damage of articular cartilage and a decreased joint space due to new bone formation on the joint surfaces

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

Likely causes of OA?

A
  • increased age
  • trauma - fractures, joint instability
  • deformity - congenital
  • occupation - sports people, builders
  • obesity!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical features of OA

A
  • NO systemic factors
  • pain - insidious onset, relieved by rest aggravated by activity
  • swelling - intermittent or continuous
  • stiffness - worse after long rest (waking) but doesn’t last as long as RA stiffness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs on examination of OA.

A

-heberdens + bouchards nodes (palpable osteophytes)
(heberdens is distal - think outer hebredies)
-swelling
-muscle wasting
-deformity
-decreased ROM
-crepitus

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

diagnostics for OA.

A
  • XRAY - most joints
  • CT - foot, ankle, hand, spine - because can be difficult on XR
  • bloods - negative RA screen
  • diagnostic steroid injection - if it works.. its OA
  • arthroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Xray findings for O

A

LOSS

  • loss of joint space
  • osteophytes
  • subchondral cysts
  • subarticular sclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 principles of OA management?

A
  • conservative - decrease load (weight loss), relieve pain(NSAIDS - tablet/topical), increase movement (physio)
  • injection - steroids
  • surgery - remove pain, improve function, correct deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the surgical options of OA?

A
  • joint debridement
  • joint excision
  • joint fusion
  • joint replacement (arthoplasty)

FU clinic 2 months - 6/52 stick/crutches w/ physio.

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

Tell me about hip OA.

A
  • RF - woman, increased age, obesity, DDH
  • Sx - groin ache post exercise relieved by rest
  • Red flag - night pain, rest pain, >2hrs morning stiffness
  • Oxford hip pain scoring system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications of a hip replacement, acute + chronic plz?

A

acute - VTE, intraoperative fracture, nerve damage

chronic - aseptic loosening, pain, dislocation, infection

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

Define RA.

A
  • A chronic autoimmune inflammatory disease affecting the joints symmetrically - SYNOVIAL joints
  • affects women more than men (3x pre-menopausal), 40-50 onset.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some risk factors of RA?

A
  • SMOKING
  • genes and FH
  • gender -woman
  • defective cell meditated immunity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is rheumatoid factor? what is the % of RA patients it’s present in?

A
  • auto-antibody against IgG therefore effecting ones immunity
  • 80% but still not specific for RA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the presentation of RA?

A
  • SYSTEMIC FEATURES - fatigue + malaise, fever, weight loss
  • symmetrical joint disease mainly affecting the hands and feet (>80%)
  • pain + swelling
  • early morning stiffness lasting longer than 30 mins
  • larger joints affected later in disease causes (all can be apart from L spine)
  • POSITIVE MCP SQUEEZE TEST
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some extra-articular manifestations of RA?

A
  • lungs - pleural effusion, Rhem nodules, fibrosis
  • heart - pericardial effusion
  • vascular - leg ulcers, raynauds
  • eyes - dryness, scleritis, episcleritis, ulceration
  • neuro - mild peripheral neuropathy, myelopathy
  • kidney - amyloidosis - BAD kills 10% of RA pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hand signs for RA?

A
  • Z thumb deformity
  • ulnar deviation of fingers
  • swan neck deformity
  • wrist subluxation
  • NODULES ON ELBOWS - examination.. do it
17
Q

What’s the most useful blood test in RA?

A

-anti-CCP

18
Q

bloods for RA?

A
  • FBC - normocytic, normochromic anaemia
  • anti-CCP (cyclic citrullinated peptide)
  • Rheum factor
  • increase CRP ESR
19
Q

Xray findings for RA?

A 
LOJJ
loss of joint space 
Oedema of the soft tissue
juxta-articular osteopenia 
joint deformity
20
Q

GP management of suspected RA?

A
  • 2 week referral to early arthritis clinic to prevent joint deformity
  • analgesia to cover them in the meantime
21
Q

Management of RA?

A
  • no cure but induce remission and return to normal functioning
  • DMARDS + corticosteroids to induce remission
  • MTX most frequently used
  • other = azathioprine, sulfasalazine, hydroxychloroquine
22
Q

What are the monitoring requirement for methotrexate? Tell me why though?

A
  • FBC & LFTs
  • myelosuppression
  • liver cirrhosis
23
Q

What are the indications for TNF inhibitors in RA? give me some examples of them too please.

A
  • failure to control disease with a least 2 different DMARDS
  • infliximab, enteracept, adalimumab
24
Q

Give some info about juvenile idiopathic arthritis.

A
  • joint pain/swelling/stiffness >6/52
  • <16 years old
  • no other causes
  • 7 subtypes dependent on presentation
25
Q

How does one monitor RA’s response to treatment?

A
  • CRP

- DAS - disease activity scoring

Ortho & Rheum (9 decks)

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