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Med School Year 2 Flash Cards > Polyarticular Arthritis > Flashcards

Polyarticular Arthritis Flashcards

1
Q

Viruses that cause polyarthritis

A

Parvovirus B19 (acute, small joints, lacy/malar rash), hepatitis –> ACUTE, SELF LIMITED DX

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2
Q

Bacterial that can cause polyarthritis

A

Directly through N. gonorrhoeae or indirectly though reactive arthritis bugs (Salmonella, Shigella, Campylobacter, Yersinia, Chlamydia)

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3
Q

Gout is suspected in patients taking ____, degenerative changes in ______ and ______.

A

Taking diuretics

DIP (Heberden’s nodes) and PIP (Bouchard’s nodes)

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4
Q

Inflammatory arthritis

A

Infectious arthritis, gout, rheumatoid arthritis, SLE, reactive arthritis

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5
Q

Signs of inflammation arthritis

A

erythema, warmth, pain, swelling, systemically: fatigue, weight loss, fever, morning stiffness lasting longer than one hour

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6
Q

Crepitus indicates

A

irregularities of articular cartilage –> OA, injury, previous inflamm. NEED TO PALPATE ALL JOINTS

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7
Q 
Distribution:
DIP and PIP
PIP and MCP
DIP, PIP, MCP
Large joints of LE
A 
Distribution:
OA
RA
Psoriatic, crystal, sarcoidosis
Spondyloarthropathies
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8
Q

Symmetry:

  1. Symmetric
  2. Asymmetric
A

Symmetry:

  1. RA, SLE, polymyalgia rheumatic, viral arthritides, serum sickness
  2. Psoriatic, reactive, gout
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9
Q

Axial involement seen in what diseases

A

OA: lower back, neck
Spondyloarthropathies: insidious chronic LBP

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10
Q

Migratory arthritis is

A

rapid onset of swelling in one or two joints with resolution over a few days, as symptoms resolve they emerge in another joint; seen in gonococcal arthritis, rheumatic fever, sarcoidosis, SLE, Lyme, bacterial endocarditis, Whipple’s

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11
Q

Gout presents at this time in a pts life

A

20 yrs after puberty in men and 20 years after menopause in women

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12
Q

What disease is associated with: pyoderma gangrenosum, HLAB27, aortic regurgitation, upper lobe lung, sacroilititis

A

ankylosing spondylitis

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13
Q

What disease is associated with: malar rash, anemia, thrombocytopenia, leukopenia

A

Parvovirus B19 or SLE

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14
Q

What disease is associated with: heliotrope, Gottron’s papules, eosinophilia, elevated CPK

A

dermatomyositis

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15
Q

What is associated with: keratoderma blennorrhagicum, urethritis, prostatitis, diffuse lung fibrosis, HLA-B27,

A

reactive arthritis

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16
Q

What is associated with: pyoderma gangrenosum, iritis/uveitis/conjunvtivitis, ischemic optic neuritis, oral ulcers, bloody sinusitis, lung nodules, hematuria/proteinuria, c-ANA

A

Wegener’s granulomatosis

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17
Q

What disease are these sx associated with: worsen with activity esp following rest (gelling), morning stiffness less than 30, joint locking/instability, effects hands/knees/hips/spine, asymmetric

A

osteoarthritis

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18
Q

first line tx for OA

A

encourage regular exercise, weight loss, PT, acetaminophen or NSAID (next line is glucoasamine/chondroitin –> opioid –> corticosteroid –> hyaluronic acid injection –> surgery, total knee replacement)

19
Q

genetic association with RA and environmental trigger

A

HLA DR4 and DRB1

smoking

20
Q

what presents like: stiffness multiple joints (wrists/PIP/MCP), morning stiffness >1hr, boggy swelling, arthralgias, fatigue, weight loss, low grade fever

A

RA

21
Q

Two blood problems associated with RA

A

anemia of chronic disease and GI bleeding from corticosteroids/NSAIDs

22
Q

patients with liver disease or renal impairment can not take ______ for RA tx

A

methotrexate

23
Q

positive signs for RA classification

A

1 joint with synovitis (with other causes ruled out), positive RF and positive ACCP, abnormal CRP and ESR, sx >6weeks –> need a score of 6/10 for RA

24
Q

leading cause of death in patients with RA

A

accelerated atherosclerosis

25
Q

felty syndrome

A

RA, splenomegaly, neutropenia, thrombocytopenia

26
Q

first line nonbiologic treatment in patients with ACTIVE RA

A

methotrexate (unless contraindicated or not tolerated)

27
Q

RA tx in patients with low disease activity

A

sulfasalazine or hydroxychloroquine

28
Q

first line biologic treatment in patients with RA

A

TNF inhibitors

29
Q

short term management of RA

A

corticosteroids and NSAIDs

30
Q

remission of RA is seen mostly in this type of patient

A

males, non smokers, younger than 40, OR patients w/o elevated acute phase reactants or positive RF/Anti CCP in late onset disease

31
Q

primary lesion in spondyloarthropathies

A

enthesitis

32
Q

Which spondyloarthropathy: late teens to adult, males, HLAB27, sacroilitis, asymmetric arthritis, symm sacroilitis, enthesitis, uveitis, ulcers, aortic regurg, upper lobe fibrosis, syndesmophytes, inflammatory back pain, prostatitis, IgA nephropathy

A

Ankylosing spondylosis

33
Q

Which spondyloarthropathy: late teens to adult, males, asymmetric sacroilitis, asymmetric arthritis, enthesitis, dactylitis, circinate balanitis, keratoderma blennorrhagicum, onycholysis, ulcers, aortic regurg, diarrhea, urethritis, cervicitis

A

reactive arthritis

34
Q

Which spondyloarthropathy: 35 to 45 yoa, asymm sacroilitis, asymm arthritis, psoriasis, onycholysis, uveitis, ulcers, aortic regurg, pencil in cup in DIP

A

psoriatic arthritis

35
Q

Which spondyloarthropathy: any age, symm sacroilitis, asymm arthritis, erythema nodosum, pyoderma gangrenosum, clubbing, uveitis, ulcers, aortic regurg, Crohn’s, UC

A

IBD associated

36
Q

Labs for spondyloarthropathy (+ and -)

A

+HLAB27, -RF, +ESR, +CRP, anemia of chronic disease, inflammatory synovial fluid

37
Q

axial arthritis progresses from sacroiliac to cervical spine (what disease?) –> limited spinal mobility (what test?)

A

ankylosing spondylitis, Schober’s test for spinal mobility (bamboo spine, squaring of vertebral bodies)

38
Q

ethesitis is what and presents like

A

inflammation at Achilles tendon and plantar fascia calcaneal insertions; presents as heel pain, aggravated by rest and improved with activity

39
Q

Reiter’s syndrome is

A

nongonoccocal urethritis, conjunctivitis, arthritis

40
Q

reactive arthritis organisms

A

Chlamydia, Ureaplasma, Shigella, Salmonella, Yersinia, Campylobacter

41
Q

treatment of reactive arthritis begins with

A

NSAIDs and Sulfasalazine for chronic reactive arthritis and corticosteroids for controlling disease in individual joints

42
Q

treatment of psoriatic arthritis for two components

A

skin: topical corticosteroids, retinoids, UV; joints: NSAID, oral corticosteroid or injections, and for second line MTX, sulfasalazine, cyclosporine, TNF-a inhib

43
Q

treatment for IBD associated arthritis

A

NSAIDs used cautiously bc can exacerbate the bowel disease; Sulfasalazine

Med School Year 2 Flash Cards (18 decks)

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