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Musculoskeletal Disorders > Joint Disorders - JRA, SEPTIC, GOUTY, > Flashcards

Joint Disorders - JRA, SEPTIC, GOUTY, Flashcards

1
Q

JRA

A

Juvenile rheumatoid arthritis

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2
Q

How many different types can JRA occur as?

A

Several

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3
Q

How does JRA differ from RA (thew adult form)?

A 
onset usually more acute 
systemic effects more marked 
but rheumatoid nodules absent 
large joints usually affected 
RF not usually present 
other abnormal antibodies present e.g. antinuclear antibodies (ANAs)
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4
Q

ANAs

A

antinuclear antibodies

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5
Q

How does the systemic form (Still disease) of JRA develop?

A 
with fever
rash
lymphadenopathy 
hepatomegaly
as well ass joint involvement
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6
Q

What does a second form of JRA cause?

A

polyarticular inflammation similar to adult form

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7
Q

What does a third form of JRA involve?

A

four or fewer joints
but cause uveitis…
inflammation of iris, ciliary body, choroid (uveal tract) in eye

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8
Q

In how many joints does Infectious (Septic) Arthritis develop?

A

usually develop in a single joint

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9
Q

How does the joint appear in Infectious (Septic) Arthritis?

A

red, swollen, painful
decreased range movement
synovium swollen, purulent exudate forms

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10
Q

Dx Infectious (Septic) Arthritis

A

aspiration synovial fluid followed by culture and sensitivity tests - confirms

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11
Q

Cause Infectious (Septic) Arthritis

A

blood-borne bacteria e.g. gonococcus or staphylococcus source infection many cases
although anaerobic - becoming increasingly common

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12
Q

Example of Infectious (Septic) Arthritis

A

Lyme disease

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13
Q

In some cases of Infectious (Septic) Arthritis, what is there a Hx of?

A

trauma surgery

spread from nearby infection e.g. osteomyelitis

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14
Q

What is Lyme disease caused by?

A

spirochete and transmitted by ticks

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15
Q

What is Lyme disease characterised by?

A

migratory arthritis
rash developing several weeks to months after tick bite
knee and large joints most often involved

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16
Q

What is now available for Lyme disease?

A

vaccine

17
Q

What Tx is necessary Infectious (Septic) Arthritis?

A

immediate, aggressive antimicrobial tx

prevent excessive cartilage destruction and fibrosis to the joint

18
Q

Fibrosis

A

aka fibrotic scarring
pathological wound healing
connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of permanent scar tissue

19
Q

Parenchymal

A

relating to or affecting the functional tissue of an organ

20
Q

In what group is Gout most common?

A

males older than 40yrs

21
Q

What does Gout result from?

A

from deposits of uric acid and urate crystals in the joint that then cause an acute inflammatory response

22
Q

What is Uric acid a waste product of?

A

purine metabolism

normally excrete through the kidneys

23
Q

What leads to Primary Gout?

A

Hyperuricemia may develop if renal excreion is not adequate or a metabolic abnormality often agentic factor such as deficit of the enzyme uricase leading to elevated levels of uric acid (Primary Gout) is present.

24
Q

What usually precipitates a Gout attack?

A

sudden increase in serum uric acid levels usually precipitates

25
Q

What part of the body does Gout usually affect?

A

affects a single joint e.g. such as in the big toe

26
Q

What causes acute inflammation in Gout?

What if the effect of this?

A

develops from uric acid deposits
articular cartilage is damaged
inflammation causes redness, swelling of joint, severe pain

27
Q

Gout attack occurs…

A

intermittently

28
Q

Dx Gout

A

examination of synovial fluid and blood tests

29
Q

Tophus

A

large, hard nodule

consist of urate crystals precipitated in soft tissue or bone

30
Q

What do Tophus result in?

A

inflammatory response

31
Q

Typically,

How long after Gout attack do Tophi occur?

A

few years after the first attack of gout

32
Q

Where may Tophi develop?

A

joint bursae
extensor surfaces forearm
pinnae of the ear

33
Q

Tx Gout:

A

reducing serum uric acid levels - dietary, drugs changes, depending on the underlying cause

increasing fluid intake and increasing the pH
urine - promote excretion of excess uric acid

colchicine - during an acute episode
allopurinol - preventative and maintenance

normalisation serum uric acid levels

inflammtion and pain associated with acute attacks by NSAIDs should be relieved as soon as possible

34
Q

Serum Levels:

A

…

35
Q

Why is the normalisation of Serum Uric acid levels important?

A
  • important - uric acid kidney stones - threat - anyone w chronic hyperuricemia

Musculoskeletal Disorders (11 decks)

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