Clin: RA, Seronegative Arthropathies, and Gout Flashcards

1
Q

Which predisposing factor incrases the risk for severe RA?

A

Genetic factors: HLA-DRB4

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2
Q

2010 RA classification criteria includes what 4 categories?

A
  • Joint involvement: # of joints and size (smaller = more points)
  • Serology: RF and anti-CCP
  • Acute phase reactants: CRP and ESR
  • Duration of sx’s: <6 weeks or >6 weeks
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3
Q

Which score using the 2010 RA classification criteria indicates definite RA?

A

>6/10

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4
Q

Which lab values are used to monitor the tx response in RA?

A

Acute phase reactants: ESR and CRP

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5
Q

Vertebral involvement of RA has a predilection for which spinal segment?

A

C1-C2

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6
Q

Which skin manifestation presents as a tender reddish purple papule; leading to a necrotic, non-healing ulcer?

A

Pyroderma Gangrenosum

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7
Q

RA is an independent risk factor for which CV manifestation?

A

CAD –> chronic endothelial inflammation - damage

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8
Q

What are 3 toxicities you must consider when using the pyrimidine antagonist, Leflunomide, for tx RA?

A

GI + Hepatic toxicity + teratogenic!

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9
Q

What is the hallmark of spondyloarthropathy in children?

A

Enthesitis: inflammation at sites where tendons, ligaments and joint capsule insert into bone

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10
Q

What is the most common inflammator disorder of the axial skeleton?

A

Ankylosing Spondylitis

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11
Q

Which disease manifestation of the eye can be seen with Ankylosing Spondylitis?

A

Anterior uveitis = Iritis

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12
Q

Which imaging modality is most sensitive for detecting erosions and which is able to detect inflammation earliest?

A
  • CT = more sensitive for erosions
  • MRI = detects inflammation before changes seen on X-ray and CT
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13
Q

What are some of the late complications which may arise with Ankylosing Spondylitis?

A
  • Cauda equina syndrome
  • Compression fractures
  • Restrictive lung disease
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14
Q

Which PE test can help aid in the diagnosis of Ankylosing Spondylitis?

A
  • Restricted forward flexion = Schober Test: ↓ lumbar spine mobility
  • FABER test
  • Restricted chest expansion
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15
Q

Which pharmacologic agents can decrease the inflammation of the axial spine and improve mobility in pt’s with Ankylosing Spondylitis?

A

TNF-alpha blockers: Infliximab, Adalimumab

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16
Q

What are the 3 major arthritic clinical manifestations of Reactive Arthritis?

A
  • Arthritis: asymmetrical, oligo-arthritis, LE’s (ankles and knees)
  • Enthesitis: achilles tendon/plantar fasciitis
  • Dactylitis: sausage digit; fingr or toe
17
Q

Uric acid lowering agents i.e., xanthine oxidase inhibitors and uricosuric drugs should be used when?

A
  • Recurrent gouty attacks, tophi, kidney stones, cytotoxic therapy
  • Do NOT start during acute gout attack; can precipitate flare