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Human Disease Y3 > Arthritis and Rheumatology > Flashcards

Arthritis and Rheumatology Flashcards

1
Q

what is rheumatic disease ?

A

pain affecting the joints and/or connective tissue

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2
Q

what are the types of rheumatic disease ?

A

degenerative, inflammatory, soft tissue

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3
Q

which rheumatic diseases are degenerative ?

A

ostoeoarthritis, cervical spondylosis

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4
Q

which rheumatic diseases are inflammatory ?

A

rheumatoid arthritis, seronegative SpA, crystal arthropathies, connective tissue disease, septic arthritis

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5
Q

which rheumatic diseases are soft tissue ?

A

tennis elbow, golfers elbow, mechanical back pain, repetitive strain

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6
Q

what are examples of other rheumatic diseases ?

A

fibromyalgia, osteoporosis

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7
Q

what are the types of seronegative spondyloarthropathies ?

A

ankylosing spondylitis,
reactive arthritis,
psoriatic arthritis,
enteropathic arthritis

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8
Q

what are the types of connective tissue disorders ?

A 
SLE,
Sjogren's, 
scleroderma, 
polymyositis,
dermatomyositis,
vasculitis - 
giant cell arthritis, PMR, takayasu's arteritis, polyarteritis nodosa, wagerer's granulomatisis, bechet's syndrome
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9
Q

what is osteoarthritis caused by ?

A

cartilage death

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10
Q

what is rheumatoid arthritis caused by ?

A

synovial fluid inflammation and overgrowth

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11
Q

what causes ankylosing spondylitis ?

A

inflammation and be bone formation at entheses (sites where ligaments and tendons join to bone)

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12
Q

what causes gout ?

A

crystals in synovial fluid

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13
Q

what causes septic arthritis ?

A

infection

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14
Q

how do joints react to osteoarthritis ?

A

the subchondral bone (just under cartilage) becomes sclerotic,
the bone at the edges of the joint grows out forming osteophytes,
capsule becomes thickened and fibrotic,
synovium may become inflamed,
additional synovial fluid may be produced

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15
Q

describe the epidemiology of OA

A

more in women, more common in elderly after age 50

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16
Q

how do joints react to rheumatoid arthritis ?

A

generalised cartilage loss, joint space narrowing, juxta - articular osteoporosis, overgrown and invasive synovial cells, deformed joint and joint capsule

17
Q

describe the epidemiology of RA

A

more in women, 30-50 years

18
Q

what is ankylosing spondylitis ?

A

inflammation and new bone formation at entheses

19
Q

at which site does ankylosing spondylitis most commonly occur ?

A

spine

20
Q

describe the pathogenesis of ankylosing spondylitis

A

syndesmophytes (new bone spurs) forms in the spine as a result of inflammation,
bone grows out into the area of the ligaments,
spurs lengthen from recurrent attacks,
discs usually undamaged,
progressive loss of range of motion,
entire spine may become ankylosed and immovable,
synovitis in larger peripheral joints

21
Q

describe the epidemiology of ankylosing spondylitis

A

more in men, 15-30 years

22
Q

describe the processes in gout

A

sodium urate crystals form in the synovial fluid,

PMN’s migrate to the joint and cause a severe acute inflammatory response

23
Q

what is urate ?

A

a normal product of purine metabolism

24
Q

which joint is affected first in half of patients with gout ?

A

proximal interpharyngeal joint of the big toe (podagra)

25
Q

describe the epidemiology of gout

A

more in men, over 40 years old, no children or women before menopause

26
Q

which organisms cause most joint infections in the UK ?

A

staphylococci or streptococci

27
Q

which drug is commonly used to treat all types arthritis ?

A

NSAIDs

28
Q

which drugs are used to treat inflammatory arthritis ?

A

corticosteroids,
disease modifying agents e.g. methotrexate, sulphasalazine, leflunamide,
anti TNF,
bisphosphonates

29
Q

which drugs are used to treat gout ?

A

colchicine

xanthine oxidase inhibitors

30
Q

what are the side effects of NSAIDs ?

A

upper GI effects, gastric/duodenal ulceration

31
Q

what are the side effects of disease methotrexate ?

A

hepatotoxicity, pulmonary toxicity, stomatitis

32
Q

what are the side effects of sulphasalazine?

A

skin reactions, diarrhoea

33
Q

what re the side effects of leflunomide ?

A

hypertension

34
Q

what are the side effects of anti TNF agents ?

A

increased risk of serious infection

35
Q

what are the side effects of bisphosphonates ?

A

osteonecrosis of the jaw

36
Q

what are the symptoms of stomatitis ?

A 
red patches,
mouth ulcers,
peeling,
swelling,
oral dysaesthesia,
burning mouth syndrome

Human Disease Y3 (24 decks)

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