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PP2 > Gout, LBP, & Ankylosing Spondylitis > Flashcards

Gout, LBP, & Ankylosing Spondylitis Flashcards

0
Q

Gout is determined by? By which organ?

A
  • How well breakdown & Excretion of PURINES.

- By Kidneys

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1
Q

Most common inflammatory joint disease in men over 40?

A

Gout

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2
Q

If no excretion, Purines break down resulting in? Which forms what? Causing?

A
  • ^ Uric Acid levels
  • Crystals
  • Inflammation & Acute pain
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3
Q

Genetic disposition is a risk factor for Gout. Name 4 more.

A
  • ^Alcohol
  • Obesity
  • Diuretics
  • Lead Toxicity
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4
Q

X-Rays identify ____ but not ____.

A

Chronic Gout

Not acute attacks

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5
Q

Where does crystallised uric acid deposit?
Gouty Arthritis: crystals where?
Tophi: Crystals where?

A
  • Any connective tissues (synovial fluid/membrane, cartilage)
  • Synovial fluid
  • Subcutaneous tissue
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6
Q 
Gout: S/S: 
Which serum concentraion is elevated?
Recurrent \_\_\_\_ arthritis.
What deposits around joints?
Renal?
A
  • Urate: Hyperuricemia
  • MONOARTICULAR
  • TOPHI
  • Renal Disease & Renal Stones ( for Breakdown + Excretion of Purines)
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7
Q

Gout appears in 3 clinical stages?

A

Asymptomatic Hyperuricemia
Acute Gouty Arthritis
Tophaceous Gout

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8
Q 
ACUTE Gouty Arthritis:
Urate levels?
Symmetrical? Which joints?
Aggrivated by?
Triggers? (2)
A
  • ^ Urate Hyperuricemia
  • Monoarticular (BIG TOE, knee, ankle, elbow)
  • TRAUMA
  • Drugs & Alcohol
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9
Q

(CHRONIC) Tophaceous Gout:
When does it occur?
Most common area affected?
Also occurs where?

A
  • 3-40yrs after initial (acute attack) gouty arthritis
  • EAR
  • fingers hands knees feet
    ulnar surface forearm, tibial leg, achilles tendon, elbow
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10
Q

Gout is related to what factors? (4)

A

Diabetes
Obesity
Kidney complaints
Diuretics (for ^BP)

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11
Q

Gout:
Treatment?
Avoid?

A
  • Anti-inflammatory drugs
  • Avoid ^Purine foods: Red meat, liver, kidneys & shellfish;
    Red wine, Alcohol
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12
Q

Preventative drug for Gout? Only taken when? NOT taken during?

A
  • Allopurinol (Treats Hyperuricemia) alloPURINol
  • Only: During Remission (period of subsiding symptoms)
  • NOT: Acute attack
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13
Q

LBP:

Top 3 causes?

A
  • Disc degeneration (Internal disruption OR Herniation)
  • Spinal Arthritis: Osteoarthritis & SPONDYLITIS (inflammation of vertebrae)
  • Back Injuries
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14
Q

What is Sciatica?

Caused by?

A
  • Pain in Buttock & Legs along Sciatic Nerve
  • HERNIATED (Disc protrusion) intervertebral disc in lumbar region –> COMPRESSION of Sciatic Nerve
    (Large nerve from lower back –> lower limb legs)
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15
Q

Lumbar Spondylosis?

Discogenic pain?

A
  • Degenerative changes in intervertebral disc
    Occurs with ageing
  • Originating in or from intervertebral disc
16
Q

Spinal stenosis?

Relation to Sciatica?

A
  • Narrowing of spinal canal

- Common cause of Sciatica

17
Q

Most common cause of Sciatica?

A

Peripheral Nerve root compression from intervertebral disc protrusion (hernia)

18
Q

Sciatica: S/S: 50% of > 60y.o.
Pain radiates where?
Associated with?

A
  • Along Sciatic nerve (YButtocks, posterior back of leg –> Beyond knee)
  • Muscle spasms: Paravertebral (alongside spine) & Hamstring muslces
19
Q

Spondylosis on X-Ray?

A

Osteophytes & Loss of Disc height

20
Q

Internal Disc Disruption (IDD): Genetic & Asymptomatic

- Arises from ____ changes in the ____ & ____.

A

Chemical changes
Nucleus Pulposus
Annulus Fibrosus

21
Q

What happens in IDD (Internal Disc Disruption)?

A

Nucleus Pulposus degenerates –> pressure on Annulus Fibrosus –> circumferential fissures –> pain
Disc tears & pulposus leaks into sensitive 1/3 of annulus causing sinuvertebral nerve inflammation/irritation thus pain.

22
Q

Internal Disc Disruption: disc hernia & nerve compression? External structure?

A

No & no

Retains external structure but Painful internal damage.

23
Q

Low back pain Treatment:

Acute? Chronic?

A
  • Acute: Exercise; Analgesics & NSAIDs

- Chronic: Intensive STRUCTURED exercise; SURGERY (Disc hernia & nerve root compression)

24
Q

Anklylosing Spondylitis is a ____ ____ joint disease.

____ & ____ of ____ & ____ joints.

A
  • chronic inflammatory

- Stiffening Fusion Spine Sacroiliac

25
Q

Ankylosing spondylitis: Possible genetic predisposition?

A

Antigen HLA-B27

1/8 (w/ gene) or 1/5 (family w/ gene)

26
Q

Ankylosing spondylitis:
Early stage patho?
Late stage patho?

A
  • Early: Inflammation of Ligaments & Joints

- Late: Form SYNDESMOPHYTES (bony growth on ligaments spine) –> Bones protrude –> fusion of disc

27
Q

Ankylosing spondylitis: S/S:

  • LBP & stiffness
  • Rest/Physical activity?
  • Posture?
  • Thoracic cage?
A
  • Prolonged rest: Worse
    Physical activity: BETTER; Alleviated
  • Diminished lumbar curvature (Lumbar Lordosis)
    ^Thoracic curvature aka Hunchback (Kyphosis)
  • Pain & Restricted movement of thoracic cage
28
Q

Ankylosing spondylitis: Other S/S

A

increased ERYTHROCYTE SEDIMENTATION RATE

Fibrotic lung changes, Achilles tendinitis, eye irritation and inflammatory bowel disease
Fatigue, weight loss, low grade fever

29
Q

Ankylosing spondylitis: Evaluation:
Physical examination, MRI
3 more?

A
  • X-Ray
  • HLA-B27 Antigen gene
  • ^^Erythrocyte sedimentation rate:
    10-15mm/hr male & female
    (Normal M: 0-9, F: 0-2)
30
Q

Ankylosing spondylitis: Treatment?

A

Exercise physical activity
Analgesics
NSAIDs

PP2 (10 decks)

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