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Year 4 - Rheumatology > Arthropathies > Flashcards

Arthropathies Flashcards

1
Q

Name the seropostiive arthritidies

A 
RA
SLE
Scleroderma
Vasculitis 
Sjogrens
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2
Q

Name the seronegatives

A

Ank spon
Psoriatic
Reactive
Enteropathic

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3
Q

Why makes something a seropositive condition?

A

Antibodies found in the serum

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4
Q

What can be seen on x-ray of OA?

A

Loss of joint space
Osteophytes
Sclerosis
Subchondral cysts

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5
Q

Why would you think something was inflammatory over OA?

A

Morning stiffness lasting hours
Hot
Younger age

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6
Q

Which gender is more affected by rheumatoid arthritis?

A

Women

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7
Q

Outline the pathogenesis of RA

A

Immune response initiated against synovium

Forms an inflammatory pannus around joints which attacks and denudes articular cartilage

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8
Q

How does RA typically present?

A

Symmetrical joint pain and swelling in the small joints of the hands and feet
(doesn’t affect DIPs)

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9
Q

What are the common extra-articular manifestations in RA?

A

Rheumatoid nodules on extensor surfaces
Lungs: pleural effusions, interstitial fibrosis, pulmonary nodules
Increased CV risk
Ocular involvement: episcleritis, uveitis, nodular scleritis, keratoconjuncitivitis sicca

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10
Q

What investigations would you do for suspicion of RA?

A

Antibody screen
FBCs
X-rays

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11
Q

Which is more specific for RA: anti-CCP or rheumatoid factor?

A

Anti-CCP

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12
Q

What is first line treatment for RA?

A

Methotrexate (DMARDs)

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13
Q

What do you do if 1 DMARD isnt helping?

A

Add another DMARD

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14
Q

What do you need to prescribe alongside methotrexate?

A

Folic acid

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15
Q

What can you give before the DMARD starts working?

A

IM Steroids

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16
Q

When would biologics be considered?

A

After multiple DMARDs havent worked and disease activity still high (DAS >5.1)

17
Q

What is the typical presentation of ank spon?

A

Young male, back pain, SI joint pain, morning stiffness thats better with exercise

18
Q

What is a syndesmophyte?

A

Bony outgrowths with bridge the intervertebral discs causing pain

19
Q

What is it that gets attacked in the seroneg arthropathies?

A

Entheses

20
Q

What test can be done on examination for ank spon?

A

Schobers test

21
Q

What investigations should be done with suspicion of ank spon?

A

X-ray
MRI
Genetic studies

22
Q

What genetic mutation is associated with ank spon?

A

HLA-B27

23
Q

What is commonly seen on x-ray with ank spon at presentation?

A

Nothing

24
Q

What can be seen on MRI in ank spon?

A

Bone marrow oedema

Enthesitis of spinal ligaments

25
Q

What are the main treatment options for ank spon?

A

Physio
NSAIDs
Biologics

26
Q

Why dont you use DMARDs for ank spon?

A

Enthesis of spine is not very vascular so DMARDs can reach it properly

27
Q

When are biologics given in ank spon?

A

Trial of two NSAIDs plus physio for 4 weeks each

28
Q

When is surgery considered in ank spon?

A

Potentially for associated knee and hip but not on the spine!

29
Q

How does psoriatic arthritis present?

A

A symmetrical oligoarthritis in people with skin conditions

Associated with nail changes and dactylitis

30
Q

What is arthritis mutilans?

A

Particularly aggressive form of psoriatic arthritis

31
Q

How is psoriatic arthritis treated?

A

Similar to RA
Methotrexate, moving onto DMARDs if particularly aggressive
Joint replacement in large joints
Joint fusion in smaller joints

32
Q

How does enteropathic arthritis occur?

A

Oligoarthritis in peripheral joints in people who suffer from IBD

33
Q

What is the main treatment of enteropathic arthritis?

A

Control the IBD

34
Q

Which infections are the typical for reactive arthritis?

A

Chlamydia, neisseria, salmonella, campylobacter

35
Q

How does reactive arthritis?

A

Inflammation of the large joints 1-3 weeks following infection

36
Q

Which joint is most commonly affected in reactive arthritis?

A

The knee

37
Q

What is Reiter’s syndrome?

A

Urethritis
Uveitis/conjunctivitis
Arthritis

38
Q

Why does urethritis occur in seroneg arthropathies?

A

Enthesitis of the choroid muscle attaching onto the orbit

39
Q

How do you treat reactive arthritis?

A

Usually self-limiting
Control the underlying infection
DMARDs in chronic cases

Year 4 - Rheumatology (5 decks)

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