GEP (Life Structure) Week 4 Flashcards
Bone Overview of the hand and wrist
Bones of the Carpel
What are the 4 main muslce of the Hand
4 main muscle groups:
Thenar muscles
Hypothenar muscles
Interossei
Lumbricals
Overview of the Thenar Muscles
Muscles of the hypothenar
What are the muscles of the lumbiricals and interossie
Ligaments of the wrist
The movement of the wrists
What is the proximal radio-ulna joint
What is the distal radio-ulna joint
Muscles of the anterior forearm
Muscles of the posterior Forearm
What is the sensory innervation of the hand
What are the brachial plexus palsies
Summary of anterior compartment of forearm
Summary of the posterior compartment of the forearm
Summary of the muslces of the hand
Overview of Rhuematoid artheritis
Rheumatoid arthritis is an autoimmune inflammatory form of arthritis.
Immune complexes form in the joints, which leads to triggering of the immune response through complement activation or direct activation of immune cells leading to secretion of chemokines and cytokines.
This leads to inflammation of the synovium and synovial membranes.
Primarily affects small joints of hands and feet.
Risk factors:
Family history -> 2-4x increased risk (HLA)
Smoking
Female -> as for all autoimmune disease
Presentation of RA
Symmetrical arthritis lasting >6 weeks
Female
Age 50-55
Joint pain and swelling
Morning stiffness lasting >1 hour
Systemic symptoms (fatigue, muscle aches, weight loss, flu like symptoms)
Spares DIPs
Joint deformities
Swan neck
Boutonniere’s
Ulnar deviation
Rheumatoid nodules
Severe disease
Vasculitic lesions (rashes)
Pleuritic chest pain (pleuritis or pericarditis)
Scleritis
Uveitis
What is the pathophysiology of RA
Investigations of RA
What is DAS 28
The DAS28 is a measure of disease activity in rheumatoid arthritis (RA). DAS stands for ‘disease activity score’, and the number 28 refers to the 28 joints that are examined in this assessment.
Number of swollen joints -> out of 28
Number of tender joints -> out of 28
Measure ESR or CRP
Ask patient to make global assessment of health
Management of RA
Biologics as treatment
Biological drugs, commonly referred to as biologics, are a class of drugs that are produced using a living system, such as a microorganism, plant cell, or animal cell
Used in moderate-to-severe and refractory disease
Target points in the inflammatory system
Overview of Psoriatic Artheritis
Inflammatory arthritis associated with psoriasis.
Occurs in about 20% of those with psoriasis.
Shares many clinical features with spondyloarthropathies and rheumatoid arthritis.
Usually seronegative, but can can be positive for anti-CCP and RF.
Clinical manifestations are varied.
Management is similar to RA
Risk factors
Psoriasis
Family history of psoriasis or psoriatic arthritis
History of tendon or joint trauma
Infection
Smoking
Presentation of Psoriatic artheritis
Joint pain and stiffness
Prolonged morning stiffness >30 mins
Peripheral arthritis
Early PsA may just involve a few lower extremity joints e.g. knees
Dactylitis
History of scalp or nail problems (in patients without known diagnosis of psoriasis)
Enthesitis
Spinal stiffness
Reduction of cervical spine mobility
Uveitis
Inflammatory bowel disease
Investigations of psoriatic artheritis
Inflammatory compared to non-inflammatory
Inflammatory and Non-inflammatory of the hand
Overview of Gout
Overview of septic artheritis
Overview of reactive artherisit
Overview of carpel tunnel syndrome
MICRA DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are a class of drugs indicated for the treatment of inflammatory arthritides, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS
What are the key side effects of DMARDs
