Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rheumatology > Osteoarthritis + Rheumatoid Arthritis > Flashcards

Osteoarthritis + Rheumatoid Arthritis Flashcards

1
Q

What are the four subtypes of inflammatory arthritis?

A

Seropositive
Seronegative
Infectious
Crystal induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the seropositive inflammatory arthritis?

A 
Rheumatoid arthritis
Connective tissue diseases:
- Lupus
- Scleroderma
- Vasculitis
- Sjogren's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the seronegative inflammatory arthritis?

A

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthritis
IBD arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the pain + stiffness seen in osteoarthritis

A

Mechanical pain–> worse on activity, relieved by rest
(may eventually be present at rest or at night)

Usually morning stiffness lasting < 30 minutes
–> inactivity gelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the common sites for OA?

A

Cervical spine, lumbar spine, hip, knee
Foot –> MTP joint
Hand –> DIP, PIP, 1st IP, 1st MCP, CMC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which general findings may bee seen on examination of an OA joint?

A

Crepitus
Joint swelling –> bony enlargements due to osteophytes
Joint tenderness/effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which bony enlargements may be seen in OA fingers?

A

DIPs –> Heberdens nodes

PIPs –> Bouchards nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which findings may been seen on examination of an OA knee?

A

Effusion
Crepitus
Reduced ROM
Bakers cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How might pain present in an OA hip?

A

Pain in groin, radiating to the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is OA diagnosed?

A

Clinical + xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the X-ray findings in an OA joint?

A

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the non-pharmacological management options for OA?

A 
Explanation
Physio --> muscle strengthening
Weight loss
Exercise
Trainers, insoles, walking stick
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the step wise approach to pharmacological management of OA?

A
  • Paracetamol + topical NSAIDs
  • Topical capsaicin for knee or hand
  • Oral opioids
  • Oral NSAIDs/COX-2 inhibitor
  • Intra-articular steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the cardinal features of an inflammatory arthritis?

A 
Joint pain + swelling
Morning stiffness > 30 mins
Improvement with exercise 
Synovitis on examination 
Raised inflammatory markers (CRP +PV)
Extra-articular symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the main structure involved in RA?

A

Synovium (lines joint capsules and tendon sheaths)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the pathophysiology in RA?

A

Inflammation of synovium –> joint destruction, tendon ruptures and soft tissue damage –> joint instability and subluxation

17
Q

What are the primary clinical features in RA?

A

Rapid onset
Symmetrical synovitis (doughy swelling)
Morning stiffness > 30 mins

18
Q

Which joints are most commonly affected in RA?

A

Small joints of hands and feet

–> PIPs, MCPs and MTPs (NOT DIPs)

19
Q

What are some examination features of RA?

A

Doughy swelling of affected joints
Positive compression tests of MCP and MTP joints
Later:
- Deformities
- C-spine affected –> altlanto-axial subluxation
- Tendon ruptures

20
Q

Which deformities may develop in the hands of someone with RA?

A

Boutonniere deformity

Swan-neck deformity

21
Q

What are some of the extra-articular features of RA?

A

Rheumatoid nodules (extensor surfaces or sites of frequent mechanical irritation)
Lungs –> effusions, interstitial fibrosis, pulmonary nodules
Increased risk of CVD
Eyes –> keratoconjunctivitis sicca, episcleritis, uveitis

22
Q

Which blood test results may be seen in RA?

A 
Autoantibodies:
- anti-CCP (most specific so preferred test)
- rheumatoid factor
Increased inflammatory markers:
- CRP, ESR and plasma viscosity
23
Q

What are the xray findings in RA?

A

Early –> normal, soft tissue swelling, peri-articular osteopenia
Late –> erosions, subluxations

24
Q

Which mode of imaging may be useful in RA before xray features are present?

A

USS –> shows synovitis in early disease

25
Q

What are the principles of RA management?

A 
Early DMARDs --> within 3 months of symptom onset
Education
Symptom relief
STOP SMOKING
Screen for CVD and osteoporosis
26
Q

What is the first line DMARD used in RA and name 3 others?

A

Methotrexate first line

Sulfasalazine, leflunomide, hydroxychloroquine

27
Q

What are some side effects associated with the DMARDs used in RA?

A 
Bone marrow suppression
Infection
Deranged LFTs
Pneumonitis
Nausea
28
Q

Which drugs are used for symptom relief in RA?

A

Paracetamol
NSAIDs
IM/intra-articular steroids
Oral steroids (short term for flares)

29
Q

What is the criteria for starting biologic therapy for RA?

A

Tried 2 DMARDs + DAS 28 score > 5.1

30
Q

What are some of the risks associated with biologics?

A

Increased risk of infection especially TB

? risk of skin cancer

31
Q

In which conditions are biologics contraindicated?

A

Pulmonary fibrosis

HF

32
Q

What is the DAS 28 score and which 4 domains are included?

A

Measure of disease activity in RA

  • tender joint count
  • swollen joint count
  • CRP/ESR
  • visual analogue score (patient’s own assessment)
33
Q

Which DAS28 score indicates remission and which indicates high disease activity?

A

Remission - < 2.6

High disease activity - > 5.1

Rheumatology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions