Causes of mono-arthritis

Question 1

What does arthralgia mean?

Answer 1

Pain arising from a joint.

Question 2

What does the term arthritis mean?

Answer 2

Inflammation of a joint.

Question 3

What is mono-arthritis?

Answer 3

Arthritis of one joint.

Question 4

What is oligoarthritis?

Answer 4

Arthritis of 2-4 joints.

Question 5

What is polyarthritis?

Answer 5

Arthritis of >4 joints.

Question 6

What is fibromyalgia?

Answer 6

A condition characterised by chronic widespread pain & allodynia.

Question 7

What is septic arthritis?

Answer 7

Acute inflammation of a joint due to direct joint infection.

Question 8

What are the main causes of septic arthritis?

Answer 8

Mainly bacterial:
> Staph aureus - most common.
> Gonococcus - in young adults.
> Tb.

Rarely viral or fungal.

Question 9

What are the main symptoms of septic arthritis?

Answer 9

Pain.
Swelling.
Erythema.

Question 10

What are the pre-disposing factors for septic arthritis?

Answer 10

Prosthetic joints.
Immunsuppression.
Elderly.
Existing joint damage.
IV drug abuse.

Question 11

What is gout?

Answer 11

Arthritis due to uric acid crystals in the joint space.

Question 12

What causes gout?

Answer 12

Hyperuricaemia.

Question 13

What is uric acid formed from?

Answer 13

Purines.

Question 14

What enzyme converts purine > uric acid?

Answer 14

Xanthine oxidase.

Question 15

How is uric acid removed from the body?

Answer 15

Renal excretion.

Question 16

What joint is most commonly affected by gout?

Answer 16

Metatarsal-phalangeal joint at the base of the big toe.

Question 17

What are the causes of hyperuricaemia?

Answer 17

Purine rich diet (i.e. beer).
Increased purine synthesis (i.e. psoriasis).
Decreased renal excretion.

Question 18

What drugs cause decreased renal excretion?

Answer 18

Aspirin.
Thiazide diuretics.
Furosemide.
Ethambutol & pyrazinamide.

Question 19

What are the two types of drugs used for uric lowering therapy? Give examples.

Answer 19

Xanthine oxidase inhibitors:
> Inhibit uric acid synthesis.
> E.g. Allopurinol & Febuxostat.

Uricosuric agents:
> Increased the excretion of uric acid.
> E.g. Sulphinpyrazone, Probenecid, Benzbromarone.

Question 20

What drug shouldnt be used for ULT in patients with renal impairment? What should be used instead?

Answer 20

Allopurinol shouldnt be used.

Benzbromarone can be used in patients with renal impairment.

Question 21

What is pseudogout?

Answer 21

Arthritis caused by accumulation of calcium pyrophosphate dihydrate.

Question 22

What are the causes of pseudogout?

Answer 22

Hyperparathyroidism.
OA.
Diabetes.
Haemochromatosis.
Acromegaly.

Question 23

What demographic does pseudogout mainly affect?

Answer 23

Elderly women.

Question 24

What demographic does gout mainly affect?

Answer 24

Middle aged men.

Question 25

What joints does pseudogout mainly affect?

Answer 25

Knee’s & wrists.

Question 26

What is reactive arthritis?

Answer 26

Arthritis that develops following an infection elsewhere in the body.

Question 27

What is the most common cause of reactive arthritis?

Answer 27

Chlamidyia.

Question 28

What is Reiters syndrome?

Answer 28

Characteristic signs of reactive arthritis which include:
> Arthritis of large joints.
> Inflammation of the eye (i.e. uveitis).
> Urethritis or cervicitis.
> Psoriasis.

Question 29

What is sero-negative arthritis? Give some examples.

Answer 29

Arthritis with negative rheumatoid factor antibody in serum.
Examples:
> Reactive arthritis.
> Psoriatic arthritis - arthritis in individuals with psoriasis.
> Ankylosing spondylitis - chronic inflammatory arthritis of the vertebral column.