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Year 3 - MSK > Gonnococcal arthritis > Flashcards

Gonnococcal arthritis Flashcards

1
Q

What are the two complications of gonococcal arthritis? What are the features of the latter?

A

Localised septic arthritis

or arthritis/dermatitis syndrome

  • Tenosynovitis
  • Rash
  • Migratory polyarthritis
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2
Q

Treatment

A

IV cephalosporin

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3
Q

Neisseria gonorrhoea colonises which part of the body?

A

GU tract
Rectum
Pharynx

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4
Q

Epidemiology

A

F>M

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5
Q

What are the symptoms of gonorrhoea?

A

Often asymptomatic

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6
Q

Osteoarthritis vs rheumatoid arthritis

A 
Osteoarthritis: 
More in DIP
Herbenden's nodes (DIP)
Squaring at base of thumb 
Bouchard's nodes (PIP)
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7
Q

?

A

avascular necrosis of teh scaphoid if fractured

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8
Q

What is de quervain’s tenosynovitis?

A

Inflammation of first tensoynovitis??

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9
Q

Features of osteoarthritis on xray

A 
Joint space narrowing 
Whitening around joint 
Osteophyte formation (new bone formation)
Subchondral cysts
Subchondral sclerosis
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10
Q

Risk factors for osteopathic

A 
FH
Prior trauma
Paget's
RA
Acromegaly
Alkaptonuria (metabolic d
Obesity
Manual work/sport
Neuropathic joint (if they can't feel their leg, it's likely they'll put too much load onto it
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11
Q

What is alkpatonuria?

A

Lack of homogenisitic dioxygenase resulting in darkening of urine/connective tissues

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12
Q

Management

A 
Education - no drugs, chronic 
Physical measures
-lose weight 
physiothearpy 
OT 
Pain
Paracetamol
Topical NSAIDs/capsaicisn 
Avoid oral NSAIDS/codeine/tramaldol 
Avoid prednisolone

Joint infection
intra-articular corticosteroids

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13
Q

Pseudo gout - where and who does it affect?

A

Knee
Wrists
OLDER WOMEN

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14
Q

What are the crystals in pseudogout?

A

Calcium pyrophosphate crystals

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15
Q

What is gout?

A

Increased uric acid deposition?

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16
Q

Mechanisms of gout formation

A

High purine load
High urate production
Reduced urate excretion

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17
Q

What is the polarisation of crystals for gout? What is the colour?

A

NEGATIVELY birefringent -> yellow or blow

needle shaped crytals

18
Q

If the uric acid deposition is in the soft tissue?

A

Tophi

19
Q

What is seen on xray of joint in long term?

A

Periarticular/rat bit erosions

20
Q

Management of gout in acute attack

A

Colchicine 500mcg twice a day
NSAIDs 500mg twice a day
Prednisoone 15-20mgs for 5-7 days
Inject steroid

21
Q

Chronic disease treatment

A

Allopurinol or
Febuxostat

Dietary advice

22
Q

Low purine diet

A 
Reduce alcohol, esp beer
Fish 
game 
Offal
Moderate vegetables such as spinach, cauliflower, asparagus, mushrooms
MOderate pulses 
Moderate meat and fish
Avoid obesity
23
Q

What is chondrocalcinosis?

A

Calciump yrophosphate deposition in the cartilage

24
Q

Antibodies for RA

A

Anti-CCP
95% specific RA
60-70% sensitive RA

IgM against IgG Fc
60-70% specific/sensitive

25
Q

RA xray changes

A

Periarticular osteopenia
Erosive damage
Loss of ulna stylid

26
Q

Complications/signs of RA if really bad

A 
Swan neck 
Boutonniere
Z thumb 
Ulnar deviation at MCP 
Volar subluxation at wrist
27
Q

Systemic disease complications of RA

A 
Scleritis
Episclertiis
Keratitis 
Interstitial lung disease
Pericarditis/effusion
Vasculitis
Nodules at ulnar
28
Q

What is Felty’s syndrome?

A

RA
Neutropenia
Splenomegaly

Associated with ?

29
Q

Three classes of DMARDs

A

Methotrexate
Biological - Anti-TNF alpha agents
Targeted synthetic - Jakinibs (oral)

30
Q

Three classes of DMARDs

A

Methotrexate
Biological - Anti-TNF alpha agents
Targeted synthetic - Jakinibs (oral)

31
Q

How do Jakinibs work?

A

Jak signalling pathway (inteferes with cytokines)

32
Q

Ank spon presentation

A

Tiredness
Low back pain and stiffness
Better with movement

33
Q

What tests would you do to check for ank spon?

A

Cervical flexion.extenstion/ration

34
Q

Schober’s test

A

mark 10cm above iliac crest and 5 cm below iliac crest from dimples of venus

Ask pt to bend forward
Distance shouldn’t reduce??

35
Q

Investigations for ank spond

A

HLA B27
CRP/ESR
MRI of whole spine and sacro iliac joints

36
Q

Four conditions in spondyloarthritis

A

Psoriatic arthrtis
Reactive
Enteropathic
Axial spondyloarthritis

37
Q

Common features of spondyloarthritis

A 
HLA B27 positive
Sacroiliitis
Arthritis
Enthesitis
Dactylitis
Iritis
38
Q

Management of spondyloarthropathies

A

Physiotherapy/hydrotherapy
NSAIDs - naproxen
Biologic DMARDs

39
Q

Monitor comorbidities

A

Osteoporosis

Cardiovascular disease

40
Q

Methotrexate if effective for which distribution of disease?

A

peripheral disease NOT axial

Year 3 - MSK (13 decks)

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