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Derm MSL/Tremfya > Psoriasis/Psoriatic Arthritis > Flashcards

Psoriasis/Psoriatic Arthritis Flashcards

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Dermatology Board Prep flashcards
1
Q

This type of psoriasis is characterized by small (3-5 millimeters) confetti-like, salmon pink, papules with fine scaling. It is most likely to affect the trunk and proximal extremities and often appears suddenly (as an initial manifestation of psoriasis in younger patients) and is often preceded by a strep upper respiratory infection.

A

Guttate Psoriasis

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2
Q

This type of psoriasis is associated with lesions that occur in skin folds (armpits, abdominal, genital, inframammary areas). Due to local moisture, lesions tend to be less scaly and more erythematous and genital involvement is observed in up to 1/3 of patients with psoriasis.

A

Inverse Psoriasis

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3
Q

This type of psoriasis is characterized by white blisters of noninfectious pus surrounded by red skin and may be localized to areas such as palms or sole of feet.

A

Pustular Psoriasis

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4
Q

This is a severe form of pustular psoriasis associated with covering most of the body and fever, chills, severe itching, change in heart rate, fatigue, and muscle weakness.

A

von Zumbusch variant

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5
Q

This type of psoriasis is characterized by generalized erythema, scales, or exfoliation that covers at least 75% of the body. The skin cannot properly maintain temperature, leading to: hypothermia, chills, dehydration from fluid loss, fever, malaise, swelling in the lower legs, congestive heart failure.

A

Erythrodermic Psoriasis

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6
Q

Mild psoriasis is considered to be what % of BSA?

A

<3%

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7
Q

Moderate psoriasis is considered to be what % of BSA?

A

3-10%

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8
Q

Severe psoriasis is considered to be what % of BSA?

A

> 10%

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9
Q

What does PASI stand for?

A

Psoriasis Area and Severity Index

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10
Q

What does PGA stand for?

A

Physician’s Global Assessment

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11
Q

What does NAPSI stand for?

A

Nail Psoriasis Severity Index

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12
Q

What does DLQI stand for?

A

Dermatology Life Quality Index

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13
Q

25% of patients with PsA are HLA-B__ positive

A

HLA-B27

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14
Q

CD__+ cells predominate in psoriatic joints

A

4

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15
Q

In PsA, the most notable contributing Th subsets are?

A

Th1 & Th17 cells

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16
Q

These cells play a central role in PsA pathogenesis?

A

CD8+ cells

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17
Q

ESR is a measure of inflammation that can be used in the diagnosis of PsA when elevated. What does ESR stand for?

A

Erythrocyte sedimentation rate

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18
Q

CRP can be elevated in PsA and is a marker of inflammation. What does CRP stand for?

A

C-reactive protein

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19
Q

What are joint erosions in PsA?

A

Bony destruction that occurs at the outer borders of a joint space in inflammatory arthritis. It is visible on radiographic images of joints.

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20
Q

What is joint space narrowing?

A

The radiographic appearance of a joint that has lost its surface cartilage. The bones in the joint are not separated by the normal of usually observed distance. They appear to be too close to each other, and they are often eburnated or sclerotic.

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21
Q

What is a bony proliferation?

A

Rapid and repeated reproduction of new bone cells. In radiographic results, bones appear irregular and “fuzzy” around the affected joint.

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22
Q

Osteolysis

A

Softening, absorption, and destruction of bony tissue, a function of the osteoclasts.

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23
Q

Pencil-in-cup deformity

A

A form of osteolysis found in severe inflammatory arthritis, especially in the finger and toe joints. The deformity is characterized by thinning of the phalangeal shaft and widening of its base proximal to the joint space.

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24
Q

Acroosteolysis

A

Congenital condition manifested by palmar and plantar ulcerating lesions with osteolysis involving distal phalanges of the fingers and toes.

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25
Q

Ankylosis

A

The abnormal union of the bones to a joint.

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26
Q

Spur formation

A

A bony growth that arises from the surface of a bone, often involving the ossification of muscular attachments; also called exostosis.

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27
Q

Spondylitis

A

Inflammation of one or more vertebrae.

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28
Q

CASPAR stands for…

A

Classification Criteria for Psoriatic Arthritis

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29
Q

The _____ criteria define psoriatic arthritis for the purpose of enrolling patients in clinical trials and providing guidance to the clinicians.

A

CASPAR

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30
Q

HAQ-DI

A

Health Assessment Questionnaire- Disability Index

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31
Q

HAQ-DI is considered a _____ status assessment

A

Functional

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32
Q

SF-36

A

Short Form 36 Health Survey

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33
Q

Higher scores on the SF-36 = better health. True or False?

A

True

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34
Q

ACR20

A

American College of Rheumatology 20

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35
Q

The ACR20 requires at least a ___% improvement in the core set measures.

A

20

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36
Q

PASDAS

A

Psoriatic Arthritis Disease Activity Score

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37
Q

This measure is a composite-weighted index including assessment of joints, entheses, dactylitis, the patient’s and physician’s global health scores, and the SF-36.

A

PASDAS

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38
Q

DAPSA

A

Disease Activity Index for Psoriatic Arthritis

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39
Q

This composite measure is based on the sum of the number of 68 tender and 66 swollen joints, the patient’s global assessment of disease activity and pain, and serum levels of C-reactive protein. It does not assess other aspects of PsA.

A

DAPSA

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40
Q

CPDAI

A

Composite Psoriatic Disease Activity

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41
Q

In this index, disease activity is assessed as absent, mild, moderate, or severe in five PsA domains (peripheral arthritis, skin and nails, axial arthritis, enthesitis, dactylitis). Treatment is based on the most active domain while considering disease activity in the others.

A

CPDAI

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42
Q

GRACE

A

GRAPPA Composite Exercise

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43
Q

This is a composite-weighted index that includes assessment of disease activity in the joints, patient and physician global health scores, quality of life, and psoriasis area severity index (PASI).

A

GRACE

44
Q

DMARD

A

Disease Modifying Antirheumatic Drugs

45
Q

Methotrexate, Sulfasalazine, and Leflunomide are examples of __________ DMARDs.

A

Conventional (non-specific)

46
Q

Cimzia (PsA tx) generic name

A

Certolizumab pegol

47
Q

Cimzia target

A

TNF alpha

48
Q

Cosentyx generic name

A

Secukinumab

49
Q

Secukinumab target

A

IL-17A

50
Q

Enbrel (PsA tx) generic name

A

Etanercept

51
Q

Etanercept target(s)

A

TNF alpha and TNF beta

52
Q

Humira generic name

A

Adalimumab

53
Q

Humira target

A

TNF alpha

54
Q

Orencia generic name

A

Abatacept

55
Q

Abatacept target

A

T cell (binds CD80 and CD86)

56
Q

Otezla generic name

A

Apremilast

57
Q

Apremilast target

A

PDE4 (Phosphodiesterase 4 inhibitor)

58
Q

Infliximab brand name

A

Remicade

59
Q

Infliximab target

A

TNF alpha

60
Q

Golimumab brand name

A

Simponi/Simponi Aria

61
Q

Simponi target

A

TNF alpha

62
Q

Stelara generic name

A

Ustekinumab

63
Q

Ustekinumab target

A

IL-12/IL-23

64
Q

Stelara binds to the p__ subunit of IL-12 and IL-23

A

p40

65
Q

Ixekizumab brand name

A

Taltz

66
Q

Ixekizumab target

A

IL-17A

67
Q

Xeljanz generic name

A

Tofacitinib

68
Q

Tofacitinib target

A

JAK (small molecule JAK inhibitor)

69
Q

JAK stands for….

A

Janus Kinase

70
Q

What are the 3 PsA guidelines?

A

GRAPPA, EULAR, ACR/NPF

71
Q

GRAPPA (guidelines) stands for?

A

Group for Research and Assessment of Psoriasis and Psoriatic Arthritis

72
Q

EULAR (guidelines) stand for?

A

European League Against Rheumatism

73
Q

ACR/NPF (guidelines) stand for?

A

American College of Rheumatology/National Psoriasis Foundation

74
Q

IGA stands for…

A

Investigator Global Assessment

75
Q

IGA assesses/measures 3 components, what are they?

Hint: I,E,S

A

Induration, Erythema, Scaling

76
Q

PASI stands for…

A

Psoriasis Area and Severity Index

77
Q

Unlike the IGA score, PASI takes into account the…

A

Body Surface Area or Area of Involvement

78
Q

ss-IGA stands for…

A

Scalp Specific Investigator’s Global Assessment

79
Q

NAPSI stands for…

A

Nail Psoriasis Severity Index

80
Q

IGA scores range from…

A

0-4 (with 4 being the most severe and 0 being clear)

81
Q

PASI scores range from…

A

0-72 (with higher scores indicating more severity)

82
Q

PGA stands for…

A

Fingernail Physician’s Global Assessment

83
Q

hf-PGA stands for…

A

Physician’s Global Assessment of Hands and/or Feet

84
Q

DLQI is a PRO that stands for…

A

Dermatology Life Quality Index

85
Q

PSSD is a PRO that stands for…

A

Psoriasis Symptom and Sign Diary

86
Q

What is onycholysis?

A

Separation of nail from underlying nail bed

87
Q

What is leukonychia?

A

White spots or streaks on nail

88
Q

This is the most common clinical sign of nail psoriasis and can be seen on the nail of digits affected by dactylitis.

A

Pitting

89
Q

These are locations where the tendon, ligament, or joint capsule inserts into the bone to facilitate joint motion.

A

Entheses

90
Q

Inflammation at the entheses is called ____.

A

Enthesitis

91
Q

True or False: with dactylitis the hands are most commonly affected.

A

False, the feet are most commonly affected.

92
Q

This criteria is the most used classification tool in PsA trials and has 99% specificity.

A

CASPAR criteria (Classification Criteria for Psoriatic Arthritis)

93
Q

This is the most used PsA clinical assessment tool.

A

ACR (either 20/50/70)

94
Q

ACR stands for?

A

American College of Rheumatology

95
Q

Which 2 variables must show improvement when looking at ACR response?

A

Swollen joint counts (SJC) and Tender joint count (TJC)

96
Q

What are two common assessment tools for axial involvement in PsA?

A

BASDAI & ASDAS

97
Q

The higher the BASDAI (PRO) score, the _____ (more or less) the patient’s disability.

A

more

98
Q

The IGA which stands for ___ assesses a patient’s psoriasis by grading psoriasis lesions for what (hint: 3 components)?

A

Induration, erythema, and scaling

99
Q

A PASI score greater than what represents severe disease?

A

10

100
Q

FACIT - F stands for?

A

Functional Assessment of Chronic Illness Therapy - Fatigue

101
Q

Higher scores on the FACIT-F represent ____ (more or less?) fatigue.

A

Less

102
Q

The most commonly used radiographic assessment tool in PsA (used to assess joint damage) is?

A

PsA-modified vdH-Sharp score

103
Q

The Sharp/van der Heijde method is a radiographic assessment in PsA clinical trials, true of false?

A

True

104
Q

The modified vdH-Sharp score includes assessment of what?

A

DIP joints

105
Q

What is considered a IGA response?

A

IGA psoriasis score of 0 or 1 AND greater than or equal to 2 grade-reduction from baseline in the IGA psoriasis score.

106
Q

This is the only enthesitis measure developed specifically for PsA?

A

Leeds Enthesitis Index of LEI

Derm MSL/Tremfya (8 decks)

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